Risk factors and impact of portal vein thrombosis in liver transplantation

Reyes, Leonardo; Herrero, J.I.; Rotellar, Fernando; Páramo, José A.

doi:10.17235/reed.2019.5819/2018

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…However, a follow-up study of 6708 subjects in Norway showed that waist circumference is the best anthropometric indicator for obesity and can predict the risk of venous thromboembolism [ 37 ]. Several studies have shown that obesity is an independent risk factor associated with PVT in patients with cirrhosis after liver transplantation [ 38 , 39 ]. Similarly, a study in France showed that central obesity may be the primary risk factor of noncirrhotic PVT [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Nomogram Model for Prediction of Portal Vein Thrombosis in Patients with Liver Cirrhosis After Splenectomy: A Retrospective Analysis of 2 Independent Cohorts

et al. 2021

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Background The aim of this study was to establish and validate an easy-to-use nomogram to predict portal vein thrombosis (PVT) in patients with cirrhosis after splenectomy and to test its predictive ability. Material/Methods This retrospective study included 315 patients with cirrhosis who underwent splenectomy at 2 high-volume medical centers. The least absolute shrinkage and selection operator (LASSO) regression method was used to select the predictors in the training cohort, and multivariable logistic regression analysis was performed to establish the predictive nomogram model. We determined the prediction value of the nomogram by the area under the receiver operating characteristic curve (AUROC), the calibration curve, and decision curve analysis. Finally, the applicability of the nomogram was internally and independently validated. Results The predictors of PVT included portal vein diameter, splenic vein diameter, body mass index, and platelet count. Based on the clinical and radiomic models, the nomogram had good predictive efficiency for predicting PVT in patients with cirrhosis after splenectomy, with an AUROC of 0.887 (0.856 in internal validation and 0.796 in independent validation). The decision curve analysis revealed that the nomogram had good clinical application value. Conclusions We successfully developed an easy-to-use nomogram to predict the probability of PVT in patients with cirrhosis after splenectomy. The nomogram can help clinicians make timely, individualized clinical decisions for PVT in patients with cirrhosis after splenectomy.

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Section: Discussionmentioning

confidence: 99%

Nomogram Model for Prediction of Portal Vein Thrombosis in Patients with Liver Cirrhosis After Splenectomy: A Retrospective Analysis of 2 Independent Cohorts

et al. 2021

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“…Another independent risk factor for PVT is the degree of thrombocytopenia, and this is also emphasized in the Baveno VII consensus report as patients with low platelet counts are at a higher risk of PVT. [ 9 , 22 , 23 ] This seems paradoxical since a low platelet count should logically predispose to bleeding. As cirrhosis and portal hypertension progress, the resultant decrease in portal flow outweighs the protective effect of low platelet count against thrombosis, and the paradoxical finding of increased PVT with lower platelet counts may thus be related to decreased portal flows that occur with the progression of portal hypertension.…”

Section: Discussionmentioning

confidence: 99%

Portal Vein Thrombosis Risk Factors in Liver Transplant Candidates

Adali

Sayar

et al. 2022

Hepatology Forum

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Background: Portal vein thrombosis (PVT) is particularly detected in advanced liver cirrhosis patients. We aimed to analyze the risk factors for PVT in liver transplant candidates. Methods: Dataset for consecutive 165 cirrhotic patients who were evaluated for liver transplantation (LT) were retrospectively analyzed. We sorted patients into two groups: Patients with PVT and patients without PVT. Included variables were: age, sex, etiology of liver disease, BMI, MELD-Na Score, Child-Pugh Score, clinical variables reflecting portal hypertension and hepatocellular carcinoma. Univariate, multivariate logistic-regression analysis were used to identify risk factors of PVT. Results: Of 165 LT candidates 46 of them had PVT (27.9 %). Presence of ascites, thrombocytopenia, history of variceal bleeding and band ligation were risk factors for PVT in univariate analysis. In multivariate analysis, only history of variceal bleeding (OR 3.45, 95% CI 1.02-11.6, P = 0.046) significantly increased the risk of PVT. Conclusion: Previous history of variceal bleeding predict PVT development in cirrhosis suggesting that severity of portal hypertension is a major predictive factor for PVT in patients with cirrhosis. Future prospective studies are needed to risk stratifying cirrhosis patients prior to liver transplantation for future PVT development and to define the prophylactic role of anticoagulation in these patients.

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“…A growing body of data suggests that an association between PVT development and esophageal varices. The presence of esophageal varices is significantly correlated with a higher rate of PVT, demonstrating esophageal varices may be an important part evaluating the risk of PVT (25)(26)(27). In this study, esophageal varices was identified as a significant PVT predictor in cirrhotic patients.…”

Section: Figurementioning

confidence: 99%

Establishment and verification a nomogram for predicting portal vein thrombosis presence among admitted cirrhotic patients

et al. 2023

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BackgroundPortal vein thrombosis (PVT) is an increasingly recognized complication of cirrhosis and possibly associated with mortality. This study aims to evaluate provoking factors for PVT, then establish a concise and efficient nomogram for predicting PVT presence among admitted cirrhotic patients.Materials and methodsAll cirrhotic patients admitted in Hunan Provincial People's Hospital between January 2010 and September 2020 were retrospectively reviewed, the clinical and laboratory data were collected. Multivariate logistic regression analysis and the least absolute shrinkage and selection operator regression method were used for screening the independent predictors and constructing the nomogram. The calibration curve was plotted to evaluate the consistent degree between observed outcomes and predicted probabilities. The area under the receiver operating characteristics curve was used to assess the discriminant performance. The decision curve analysis (DCA) was carried out to evaluate the benefits of nomogram.ResultsA total of 4,479 patients with cirrhosis were enrolled and 281 patients were identified with PVT. Smoking history, splenomegaly, esophagogastric varices, surgical history, red blood cell transfusion, and D-dimer were independent risk factors for PVT in cirrhosis. A nomogram was established with a good discrimination capacity and predictive efficiency with an the area under the curve (AUC) of 0.704 (95% CI: 0.664–0.745) in the training set and 0.685 (95% CI: 0.615–0.754) in the validation set. DCA suggested the net benefit of nomogram had a superior risk threshold probability.ConclusionA concise and efficient nomogram was established with good performance, which may aid clinical decision making and guide best treatment measures.

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Risk factors and impact of portal vein thrombosis in liver transplantation

Cited by 4 publications

References 30 publications

Nomogram Model for Prediction of Portal Vein Thrombosis in Patients with Liver Cirrhosis After Splenectomy: A Retrospective Analysis of 2 Independent Cohorts

Nomogram Model for Prediction of Portal Vein Thrombosis in Patients with Liver Cirrhosis After Splenectomy: A Retrospective Analysis of 2 Independent Cohorts

Portal Vein Thrombosis Risk Factors in Liver Transplant Candidates

Establishment and verification a nomogram for predicting portal vein thrombosis presence among admitted cirrhotic patients

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