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Current Hepatology Reports

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15-02-2024 | Portal Vein Thrombosis

Portal Vein Thrombosis in Patients with Cirrhosis

Authors: Peter L. Wang, Vijay Ramalingam, Lauren M. Yang

Published in: Current Hepatology Reports | Issue 1/2024

Abstract

Purpose of Review

Portal vein thromboses occur in patients with cirrhosis, including those awaiting liver transplant, and uncertainty exists regarding its prognosis, workup, and optimal management.

Recent Findings

The prevalence of PVT is higher in those with more severe liver disease (24% vs 14% for Child-Pugh B/C vs A, respectively). PVT, especially those with complete occlusion, is associated with mortality and graft loss in liver transplant recipients. Increasing data on direct oral anticoagulant (DOAC) use in cirrhosis and specifically for use in patients with PVT provides physicians and patients with more appealing anticoagulation options. In addition to observation and anticoagulation, there is an emerging role of transjugular intrahepatic porto-systemic (TIPS) shunt for recanalization of the portal vein in certain patients, with prospective single-center study demonstrating 98–100% efficacy in those with complete occlusion compared to a lower rate of patency with medical therapy alone (13%).

Summary

Due to the complexities involved in assessing and managing PVTs in cirrhosis based on individual patient factors, a multidisciplinary approach with hepatologists, hematologists, interventional radiologists, and transplant surgeons is strongly recommended for patients who are transplant candidates, have recurrent thromboses or complex anatomy, and may be considered in any patient with cirrhosis.

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Title: Portal Vein Thrombosis in Patients with Cirrhosis
Authors: Peter L. Wang
Vijay Ramalingam
Lauren M. Yang
Publication date: 15-02-2024
Publisher: Springer US
Keywords: Portal Vein Thrombosis
Portal Vein Thrombosis
Portal Hypertension
Portal Hypertension
Direct Oral Anticoagulant
Direct Oral Anticoagulant
Published in: Current Hepatology Reports / Issue 1/2024
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-024-00636-9

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