Portal vein thrombosis in cirrhosis

Journal of Clinical and Experimental Hepatology
Kaiser RajaSonal Asthana

Abstract

Portal vein thrombosis (PVT) is being increasingly recognized in patients with advanced cirrhosis and in those undergoing liver transplantation. Reduced flow in the portal vein is probably responsible for clotting in the spleno-porto-mesenteric venous system. There is also increasing evidence that hypercoagulability occurs in advanced liver disease and contributes to the risk of PVT. Ultrasound based studies have reported a prevalence of PVT in 10-25% of cirrhotic patients without hepatocellular carcinoma. Partial thrombosis of the portal vein is more common and may not have pathophysiological consequences. However, there is high risk of progression of partial PVT to complete PVT that may cause exacerbation of portal hypertension and progression of liver insufficiency. It is thus, essential to accurately diagnose and stage PVT in patients waiting for transplantation and consider anticoagulation therapy. Therapy with low molecular weight heparin and vitamin K antagonists has been shown to achieve complete and partial recanalization in 33-45% and 15-35% of cases respectively. There are however, no guidelines to help determine the dose and therapeutic efficacy of anticoagulation in patients with cirrhosis. Anticoagulation therapy ...Continue Reading

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Mar 10, 2016·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Guo-Qing JiangXue-Hao Wang
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Nov 16, 2016·ESMO Open·Matthias PinterWolfgang Sieghart
Oct 9, 2020·Clinical Transplantation·Josephine BertXavier Verhelst

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