F-33 Predictors of response to anticoagulant therapy for the treatment of portal vein thrombosis (PVT) in cirrhosis patients

Abstract Background: Systematic review and meta-analysis were performed to evaluate efficacy and safety of anticoagulant therapy in patients with chronic cirrhosis complicated with portal vein thrombosis (PVT). Methods: The PubMed, The Cochrane Library and Web of Science databases were searched. The odds ratio (OR) and risks ratio(RR) with 95% CI was pooled to calculate the difference in the rate of portal vein recanalization and occurrence of bleeding events between patients who received anticoagulation and those who did not. All meta-analysis were conducted by using a random-effects model. Results: 8 studies with a total of 559 patients published between 2005 and 2019 were finally enrolled in our meta-analysis . The rate of portal vein recanalization was significantly higher with PVT who received anticoagulation and those who did not (OR = 4.689, 95% (95% CI = 3.274–6.716, P=0.000). And the pooled risk ratio of bleeding between the two groups was 0.828 (95% CI = 0.511–1.343, P=0.444). The heterogeneity was not statistically significant among studies, Begg’s funnel plot and Egger’s linear regression test were performed to evaluate publicantion bias. Conclusion: Anticoagulation therapy can significantly improve the recanalization rate of PVT patients with cirrhosis, and the bleeding related events caused by anticoagulation are relatively low, which is worthy of clinical promotion. However, more prospective trials are needed to know how to use anticoagulants.

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Non tumoral portal vein thrombosis during cirrhosis: Should anticoagulation be proposed?

10.32512/jmr.1.2.2018/4.11. ◽

2018 ◽

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Anticoagulant Therapy ◽

Control Group ◽

Case Group ◽

Early Introduction ◽

Vein Thrombosis ◽

History Of ◽

One Year ◽

The Impact

Background: Portal vein thrombosis (PVT) is considered as infrequent and pejorative event in cirrhosis. Up to date, many questions remain about therapeutic management. Aim: The objectives of this study were to assess the impact of the PVT on the progression of liver disease, to review the indications for anticoagulation and its repercussions. Materials and methods: A case-control study was conducted over a period of 12 years (2002-2013). It included 484 cases of cirrhosis. Among these patients, 41 had non tumoral portal vein thrombosis (case group). The control group included the remaining 443 patients. Results: In our study, there was no impact of PVT on the natural history of cirrhosis both in terms of complications or survival. Only the early introduction of anticoagulant therapy was associated with a re-permeabilization of portal vein at one year (OR1.6; 95% CI [1.10-2.01]). Prolonged anticoagulation was inversely correlated with recurrent PVT after treatment. However, obtaining a portal vein re-permeabilization was not correlated to a significant gain in terms of prevention of complication related to cirrhosis and survival. Conclusions: results suggest that portal vein thrombosis in patients with cirrhosis is not a formal indication for anticoagulant therapy. It should be reserved for candidates of liver transplantation, those with an extension of the PVT to mesenteric vessels or with severe prothrombotic status. Key words: portal vein thrombosis, cirrhosis, anticoagulation.

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Efficacy and Safety of Anticoagulant Therapy in Portal Vein Thrombosis

Case Medical Research ◽

10.31525/ct1-nct04173429 ◽

2019 ◽

Author(s):

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Anticoagulant Therapy ◽

Efficacy And Safety ◽

Vein Thrombosis

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Prevention of portal vein thrombosis with anticoagulant therapy in patients with hepatic cirrhosis

http://isrctn.org/> ◽

10.1186/isrctn32383354 ◽

2012 ◽

Author(s):

Erica Villa

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Anticoagulant Therapy ◽

Hepatic Cirrhosis ◽

Vein Thrombosis

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Outcomes following neonatal portal vein thrombosis: A descriptive, single-center study and review of anticoagulant therapy

Pediatric Blood & Cancer ◽

10.1002/pbc.27572 ◽

2018 ◽

Vol 66 (4) ◽

pp. e27572

Author(s):

Mihir D. Bhatt ◽

Vishal Patel ◽

Michelle L. Butt ◽

Anthony K.C. Chan ◽

Bosco Paes ◽

...

Keyword(s):

Portal Vein ◽

Portal Vein Thrombosis ◽

Anticoagulant Therapy ◽

Single Center ◽

Vein Thrombosis ◽

Single Center Study ◽

Center Study

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Safety and Efficacy of Anticoagulation in Patients with Cirrhosis: A Meta-Analysis

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2021/8859602 ◽

2021 ◽

Vol 2021 ◽

pp. 1-20

Author(s):

Huan Chen ◽

Jiaming Lei ◽

Sicheng Liang ◽

Gang Luo ◽

Mingming Deng ◽

...

Keyword(s):

Liver Cirrhosis ◽

Adverse Events ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Anticoagulant Therapy ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Safety And Efficacy ◽

Vein Thrombosis

Background and Aims. Portal vein thrombosis is a serious adverse event that occurs during liver cirrhosis. We performed a meta-analysis to evaluate the safety and efficacy of anticoagulant therapy and prophylactic anticoagulant therapy in cirrhosis patients with (/without) portal vein thrombosis. Methods. Eligible comparative studies were identified by searching the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, and CNKI. A meta-analysis was performed to calculate odds ratios and 95% confidence intervals using fixed-effects models. Recanalization and thrombus progression were defined as the primary outcomes. Secondary outcomes included adverse events and death mortality. Results. A total of 3479 patients were included in this analysis. Compared with the control group, the recanalization rate in the anticoagulant therapy group was increased P < 0.00001 in patients with cirrhosis and portal vein thrombosis without increasing adverse events. Multiple use of enoxaparin in small doses is safer than single large doses P = 0.004 . Direct oral anticoagulants are more effective P < 0.00001 and safer than traditional anticoagulants. Prophylactic anticoagulant therapy can effectively prevent portal vein thrombosis formation P < 0.00001 . Conclusions. Anticoagulation therapy can treat or prevent portal vein thrombosis in patients with liver cirrhosis and is a relatively safe treatment.

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