Home > Journals > Minerva Gastroenterology > Past Issues > Minerva Gastroenterology 2023 March;69(1) > Minerva Gastroenterology 2023 March;69(1):107-13



Publishing options
To subscribe
Submit an article
Recommend to your librarian


Publication history
Cite this article as



Minerva Gastroenterology 2023 March;69(1):107-13

DOI: 10.23736/S2724-5985.21.02861-8


language: English

Treatment of portal vein thrombosis in cirrhosis: a multicenter real life cοhort study

Aikaterini MANTAKA 1 , Nikolaos GATSELIS 2, Christos K. TRIANTOS 3, Ulrich THALHEIMER 4, Gioacchino LEANDRO 5, Kalliopi ZACHOU 2, Christos KONSTANTAKIS 3, Asterios SAITIS 2, Konstantinos THOMOPOULOS 3, Elias A. KOUROUMALIS 1, George N. DALEKOS 2, Dimitrios N. SAMONAKIS 1

1 Department of Gastroenterology & Hepatology, University Hospital of Heraklion, Heraklion, Crete, Greece; 2 Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Larissa, Greece; 3 Department of Gastroenterology, University Hospital of Patras, Patras, Greece; 4 Department of Gastroenterology, Royal Shrewsbury Hospital, Shrewsbury, UK; 5 Department of Gastroenterology, IRCCS Saverio De Bellis Hospital, Castellana Grotte, Bari, Italy

BACKGROUND: Portal vein thrombosis (PVT) is a common complication of cirrhosis and can be a cause or consequence of liver disease progression. It is unclear whether PVT treatment is affecting clinical outcomes in cirrhotics.
METHODS: This is a multicenter study of cirrhotics with PVT, initially retrospectively and thereafter prospectively registered in a data base. We studied the impact of PVT treatment on this population for efficacy, safety and the impact on survival. In survival analysis Mantel-Cox and Wilcoxon-Breslow-Gehan tests were used. A P value of <0.05, was considered significant. For statistical computations the STATA 12.1 was used.
RESULTS: Seventy-six patients were included (76% decompensated, median MELD score 12 and Child-Pugh score 7), 47% with concomitant HCC. Fifty-one patients with PVT were treated with Vitamin-K antagonists or Low-Molecular-Weight Heparin. Patients were followed up for at least 6 months after PVT diagnosis, or until death or transplantation. PV patency after 6 months was not statistically different between patients receiving or not anticoagulation (complete-partial recanalization 27.4% of treated vs. 20% of untreated, P=0.21). Median survival was statistically worse between patients treated with anticoagulation than those untreated (10 vs. 15 months, P=0.036). Less portal hypertensive bleeding and less decompensation rates were found in treated cirrhotics vs. untreated (45.8% vs. 54.2%, P=0.003 and 78% vs. 80.9%, P=0.78, respectively). Patients with HCC had worse survival when treated vs. untreated (P=0.047).
CONCLUSIONS: In our cohort of cirrhotics with PVT, treatment was feasible with acceptable side effects, but without meaningful clinical benefits.

KEY WORDS: Thrombosis; Hemorrhage; Liver cirrhosis; Safety; Heparin, low-molecular-weight; Survival

top of page