Homocysteine Serum Levels as Prognostic Marker of Hepatocellular Carcinoma with Portal Vein Thrombosis

2019 ◽  
Vol 19 (7) ◽  
pp. 532-538
Author(s):  
Saverio Latteri ◽  
Giulia Malaguarnera ◽  
Vito Emanuele Catania ◽  
Gaetano La Greca ◽  
Gaetano Bertino ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Serum Levels ◽  
High Serum ◽  
Thrombotic Risk ◽  
Mean Values ◽  
Vein Thrombosis ◽  
Thrombotic Risk Factor

Background: Portal vein thrombosis (PVT) is a common complication of endstage hepatocellular carcinoma (HCC). : The aim of our study was to evaluate the role of Homocysteine (Hcy) in HCC patient with PVT. Hcy is a sulphur amino-acid involved in two pathways, trans-sulphuration and remethylation, that involve vitamins B6, B12 and folates. Methods: We recruited 54 patients with HCC and PVT, 60 patients with HCC and without PVT and 60 control subjects. We measured serum levels of Hcy, folate, vitamins B6 and B12. Results: The comparison between HCC patients with PVT versus HCC without PVT was shown that mean values of Hcy were 6.4 nmol/L (p<0.0073) higher, LDL cholesterol were 4.8 mg/dl (p<0.0079) lower, vitamin B6 were 4.6 nmol/L(p=0.0544) lower, vitamins B 12 were 22.1 pg/ml (p=0.0001) lower. Conclusion: High serum levels of Hcy are an established thrombotic risk factor in the general population. We found significantly higher levels of Hcy in HCC patients with PVT versus both HCC patients without PVT and controls.

The Role of Interventional Radiology in the Pretransplant Management of Hepatocellular Carcinoma and Portal Vein Thrombosis

2019 ◽  
Vol 03 (04) ◽  
pp. 263-269
Author(s):  
Karen Shmelev ◽  
Bartley Thornburg
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Interventional Radiology ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
The United States ◽  
Primary Liver Tumor ◽  
Vein Thrombosis ◽  
Portal Veins

AbstractHepatocellular carcinoma (HCC) is the most common primary liver tumor and is currently the leading indication for liver transplantation in the United States. Liver transplantation may provide a curative option for patients with HCC, but some present outside of the transplant criteria. Additionally, as the criteria for liver transplant eligibility in HCC are expanded and the incidence of disease increases, waitlist times are becoming progressively longer, which increases the chance of a patient suffering from disease progression while awaiting an organ becoming ineligible for transplant. Multiple studies have demonstrated the successful use of locoregional therapies, including trans-arterial chemoembolization and trans-arterial radioembolization, in downstaging HCC to within transplant criteria, as well as in preventing progression of disease in patients already listed for transplant. Cirrhotic patients also commonly develop portal vein thrombosis (PVT), which is a contraindication to transplantation at many centers. PVT can lead to worsened outcomes after transplant depending on the type of portal venous reconstruction that is performed. The purpose of this article is to discuss the integral role of interventional radiology in the care of these patients, including the role of transarterial therapies in the pretransplant treatment of HCC and the use of endovascular techniques to recanalize thrombosed portal veins in order to establish or maintain transplant eligibility.

scholarly journals Portal Vein Thrombosis in a Preterm Newborn with Mutation of the MTHFR and PAI-1 Genes and Sepsis by Candida parapsilosis

2016 ◽  
Vol 33 (11) ◽  
pp. 1099-1103 ◽  
Author(s):  
Mario Giuffrè ◽  
Clelia Verso ◽  
Gregorio Serra ◽  
Giovanni Moceri ◽  
Marcello Cimador ◽  
...  
Keyword(s):  
Risk Factors ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Candida Parapsilosis ◽  
Homozygous Mutation ◽  
Preterm Newborn ◽  
Thrombotic Risk ◽  
Vein Thrombosis ◽  
Pai 1

Objective This report discusses the role of both congenital and acquired risk factors in the pathogenesis of portal vein thrombosis (PVT). Study Design We describe the clinical management and treatment of PVT in a preterm newborn with a homozygous mutation of the methylenetetrahydrofolate reductase (MTHFR) and plasminogen activator inhibitor-1 (PAI-1) genes and sepsis by Candida parapsilosis. Results Although literature data suggest a minor role of genetic factors in thrombophilia in the case of only one mutation, we hypothesize that combined thrombophilic genetic defects may have a cumulative effect and significantly increase the thrombotic risk. Conclusion It could be appropriate to include more detailed analyses of procoagulant and fibrinolytic factors in the diagnostic workup of neonatal thrombosis, also through the investigation of genetic polymorphisms. The anticoagulant therapy and the removal of concurrent risk factors remain basic steps for the adequate management and prevention of complications.

scholarly journals Transarterial Chemoembolization in Unresectable Hepatocellular Carcinoma with Portal Vein Thrombosis: A Perspective on Survival

2014 ◽  
Vol 29 (6) ◽  
pp. 430-436 ◽  
Author(s):  
Yadav Ajit ◽  
Hariprasad Sudarsan ◽  
Gupta Saumya ◽  
Agarwal Abhishek ◽  
Redhu Navneet ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Transarterial Chemoembolization ◽  
Vein Thrombosis ◽  
Unresectable Hepatocellular Carcinoma
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