Association between Portal Vein Thrombosis and Survival in Non-Liver-Transplant Patients with Liver Cirrhosis: A Systematic Review of the Literature

Abstract

A systematic review of the literature was performed to analyze the association between portal vein thrombosis (PVT) and survival in non-liver-transplant patients with liver cirrhosis. PubMed, EMBASE, and Cochrane Library databases were searched for all relevant papers which evaluated the prognostic value of PVT in predicting the survival of liver cirrhosis. Meta-analyses were not conducted because the ways of data expression and lengths of follow-up were heterogeneous among studies. Overall, 13 papers were included. The 5-day, 6-week, and 1-year mortality were investigated in 1, 3, and 1 studies, respectively; and all of them were not significantly different between cirrhotic patient with and without PVT. By comparison, the 3-year mortality was reported in 1 study; and it was significantly increased by the presence of PVT. The overall mortality was analyzed in 5 studies; and the association with overall mortality and PVT was significant in 4 studies, but not in another one. However, as for the cirrhotic patients undergoing surgical or interventional shunts, the overall mortality was not significantly associated with the presence of PVT in 4 studies. In conclusion, the presence of PVT might be associated with the long-term mortality in non-liver-transplant patients with liver cirrhosis, but not with the short-term mortality.

Clinical outcomes of transcatheter selective superior mesenteric artery urokinase infusion therapy vs transjugular intrahepatic portosystemic shunt in patients with cirrhosis and acute portal vein thrombosis

“…Acute PVT in 70% of patients was improved after TIPS treatment, which is consistent with previous studies that PVT disappearance occurred in 57% to 100% of patients[ 22 , 24 ]. We consider that this is consistent with the view that a reduced portal vein flow velocity is the key risk factor for PVT formation[ 7 , 14 , 25 ]. Patients with concomitant cirrhosis have significantly slower portal vein flow rates than the healthy population[ 14 ].…”

Portal Vein Thrombosis in Patients With Cirrhosis Undergoing Elective Transjugular Intrahepatic Portosystemic Shunt: Risk Factors, Warfarin Efficacy, and Clinical Outcomes

“…Moreover, previous studies also reported that the presence of PVT might be associated with the long-term mortality (3 years) in nonliver transplant patients with cirrhosis, but not with the short-term mortality (5 days, 6 weeks, and 1 year); the presence of PVT was not significantly associated with overall mortality for the cirrhotic patients undergoing surgical or interventional shunts. 33 Notably, Perarnau et al 34 showed that cumulative survival rates were not significantly different between TIPSS-treated cirrhotic patients with and without PVT (1 year: 80% vs 84%; 2 years: 72% vs 70%; and 4 years: 55% vs 52%; Figure 3. A, Cumulative variceal rebleeding rates in patients with and without PVT after transjugular intrahepatic portosystemic shunt (P ¼ .023, by log-rank test).…”

Transjugular intrahepatic portosystemic shunt for portal vein thrombosis with variceal bleeding in liver cirrhosis: outcomes and predictors in a prospective cohort study

“…Portal vein thrombosis (PVT) negatively influences the outcomes of cirrhotic patients (1)(2)(3)(4)(5)(6). However, no consensus regarding the treatment strategy of PVT in cirrhosis is well established (7,8).…”