Portal vein thrombosis in patients with end stage liver disease awaiting liver transplantation: Outcome of anticoagulation

K. T. Werner, Shawna Sando, Elizabeth J. Carey, Hugo E Vargas, Thomas J. Byrne, David D. Douglas, M. E. Harrison, Jorge Rakela, Bashar A. Aqel

Research output: Contribution to journalArticle

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Abstract

Background: The prevalence of portal vein thrombosis (PVT) increases with the severity of liver disease. Development of PVT is often accompanied by increased rate of morbidity and mortality and may affect patient candidacy for liver transplant. There is limited data regarding the role of anticoagulation therapy in patients with PVT and liver cirrhosis. Objectives: The aims of this study were to describe the prevalence of hypercoagulable disorders in patients with liver cirrhosis and PVT, and to describe the outcome of anticoagulation in patients with liver cirrhosis and PVT. Methods: A retrospective chart review was conducted of patients with liver cirrhosis awaiting liver transplant who were diagnosed with PVT between January 2005 and November 2011. Results: During the study period, 537 patients were evaluated for liver transplant. Sixty-nine (13 %) patients were diagnosed with portal vein thrombosis. Chronic hepatitis C was the cause of liver disease in 24/69 (35 %) patients, and hepatocellular carcinoma was present in 39 % of patients. In 22 patients screened for hypercoagulable disorders, hypercoagulable disorder was diagnosed in one patient (5 %). Twenty-eight (28/69) patients were treated during the study period with warfarin: PVT resolved in 11/28 (39 %), no change in 5/28 (18 %), and 12/28 (43 %) patients showed partial resolution of thrombus. Eight patients received liver transplant while on anticoagulation, and operative notes confirmed patency of PV in all eight patients. Conclusions: PVT is frequently seen in patients with end stage liver disease with prevalence of 13 %. Hypercoagulable disorder was detected in 5 % of the patients screened. Careful use of anticoagulation is safe and effective in patients with PVT.

Original languageEnglish (US)
Pages (from-to)1776-1780
Number of pages5
JournalDigestive Diseases and Sciences
Volume58
Issue number6
DOIs
StatePublished - Jun 2013

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End Stage Liver Disease
Portal Vein
Liver Transplantation
Thrombosis
Liver Cirrhosis
Transplants
Liver
Liver Diseases

Keywords

  • Anticoagulation therapy
  • Hypercoagulable disorders
  • Liver cirrhosis
  • Liver transplant
  • Portal vein thrombosis (PVT)

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Portal vein thrombosis in patients with end stage liver disease awaiting liver transplantation : Outcome of anticoagulation. / Werner, K. T.; Sando, Shawna; Carey, Elizabeth J.; Vargas, Hugo E; Byrne, Thomas J.; Douglas, David D.; Harrison, M. E.; Rakela, Jorge; Aqel, Bashar A.

In: Digestive Diseases and Sciences, Vol. 58, No. 6, 06.2013, p. 1776-1780.

Research output: Contribution to journalArticle

Werner, K. T. ; Sando, Shawna ; Carey, Elizabeth J. ; Vargas, Hugo E ; Byrne, Thomas J. ; Douglas, David D. ; Harrison, M. E. ; Rakela, Jorge ; Aqel, Bashar A. / Portal vein thrombosis in patients with end stage liver disease awaiting liver transplantation : Outcome of anticoagulation. In: Digestive Diseases and Sciences. 2013 ; Vol. 58, No. 6. pp. 1776-1780.
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title = "Portal vein thrombosis in patients with end stage liver disease awaiting liver transplantation: Outcome of anticoagulation",
abstract = "Background: The prevalence of portal vein thrombosis (PVT) increases with the severity of liver disease. Development of PVT is often accompanied by increased rate of morbidity and mortality and may affect patient candidacy for liver transplant. There is limited data regarding the role of anticoagulation therapy in patients with PVT and liver cirrhosis. Objectives: The aims of this study were to describe the prevalence of hypercoagulable disorders in patients with liver cirrhosis and PVT, and to describe the outcome of anticoagulation in patients with liver cirrhosis and PVT. Methods: A retrospective chart review was conducted of patients with liver cirrhosis awaiting liver transplant who were diagnosed with PVT between January 2005 and November 2011. Results: During the study period, 537 patients were evaluated for liver transplant. Sixty-nine (13 {\%}) patients were diagnosed with portal vein thrombosis. Chronic hepatitis C was the cause of liver disease in 24/69 (35 {\%}) patients, and hepatocellular carcinoma was present in 39 {\%} of patients. In 22 patients screened for hypercoagulable disorders, hypercoagulable disorder was diagnosed in one patient (5 {\%}). Twenty-eight (28/69) patients were treated during the study period with warfarin: PVT resolved in 11/28 (39 {\%}), no change in 5/28 (18 {\%}), and 12/28 (43 {\%}) patients showed partial resolution of thrombus. Eight patients received liver transplant while on anticoagulation, and operative notes confirmed patency of PV in all eight patients. Conclusions: PVT is frequently seen in patients with end stage liver disease with prevalence of 13 {\%}. Hypercoagulable disorder was detected in 5 {\%} of the patients screened. Careful use of anticoagulation is safe and effective in patients with PVT.",
keywords = "Anticoagulation therapy, Hypercoagulable disorders, Liver cirrhosis, Liver transplant, Portal vein thrombosis (PVT)",
author = "Werner, {K. T.} and Shawna Sando and Carey, {Elizabeth J.} and Vargas, {Hugo E} and Byrne, {Thomas J.} and Douglas, {David D.} and Harrison, {M. E.} and Jorge Rakela and Aqel, {Bashar A.}",
year = "2013",
month = "6",
doi = "10.1007/s10620-012-2548-y",
language = "English (US)",
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TY - JOUR

T1 - Portal vein thrombosis in patients with end stage liver disease awaiting liver transplantation

T2 - Outcome of anticoagulation

AU - Werner, K. T.

AU - Sando, Shawna

AU - Carey, Elizabeth J.

AU - Vargas, Hugo E

AU - Byrne, Thomas J.

AU - Douglas, David D.

AU - Harrison, M. E.

AU - Rakela, Jorge

AU - Aqel, Bashar A.

PY - 2013/6

Y1 - 2013/6

N2 - Background: The prevalence of portal vein thrombosis (PVT) increases with the severity of liver disease. Development of PVT is often accompanied by increased rate of morbidity and mortality and may affect patient candidacy for liver transplant. There is limited data regarding the role of anticoagulation therapy in patients with PVT and liver cirrhosis. Objectives: The aims of this study were to describe the prevalence of hypercoagulable disorders in patients with liver cirrhosis and PVT, and to describe the outcome of anticoagulation in patients with liver cirrhosis and PVT. Methods: A retrospective chart review was conducted of patients with liver cirrhosis awaiting liver transplant who were diagnosed with PVT between January 2005 and November 2011. Results: During the study period, 537 patients were evaluated for liver transplant. Sixty-nine (13 %) patients were diagnosed with portal vein thrombosis. Chronic hepatitis C was the cause of liver disease in 24/69 (35 %) patients, and hepatocellular carcinoma was present in 39 % of patients. In 22 patients screened for hypercoagulable disorders, hypercoagulable disorder was diagnosed in one patient (5 %). Twenty-eight (28/69) patients were treated during the study period with warfarin: PVT resolved in 11/28 (39 %), no change in 5/28 (18 %), and 12/28 (43 %) patients showed partial resolution of thrombus. Eight patients received liver transplant while on anticoagulation, and operative notes confirmed patency of PV in all eight patients. Conclusions: PVT is frequently seen in patients with end stage liver disease with prevalence of 13 %. Hypercoagulable disorder was detected in 5 % of the patients screened. Careful use of anticoagulation is safe and effective in patients with PVT.

AB - Background: The prevalence of portal vein thrombosis (PVT) increases with the severity of liver disease. Development of PVT is often accompanied by increased rate of morbidity and mortality and may affect patient candidacy for liver transplant. There is limited data regarding the role of anticoagulation therapy in patients with PVT and liver cirrhosis. Objectives: The aims of this study were to describe the prevalence of hypercoagulable disorders in patients with liver cirrhosis and PVT, and to describe the outcome of anticoagulation in patients with liver cirrhosis and PVT. Methods: A retrospective chart review was conducted of patients with liver cirrhosis awaiting liver transplant who were diagnosed with PVT between January 2005 and November 2011. Results: During the study period, 537 patients were evaluated for liver transplant. Sixty-nine (13 %) patients were diagnosed with portal vein thrombosis. Chronic hepatitis C was the cause of liver disease in 24/69 (35 %) patients, and hepatocellular carcinoma was present in 39 % of patients. In 22 patients screened for hypercoagulable disorders, hypercoagulable disorder was diagnosed in one patient (5 %). Twenty-eight (28/69) patients were treated during the study period with warfarin: PVT resolved in 11/28 (39 %), no change in 5/28 (18 %), and 12/28 (43 %) patients showed partial resolution of thrombus. Eight patients received liver transplant while on anticoagulation, and operative notes confirmed patency of PV in all eight patients. Conclusions: PVT is frequently seen in patients with end stage liver disease with prevalence of 13 %. Hypercoagulable disorder was detected in 5 % of the patients screened. Careful use of anticoagulation is safe and effective in patients with PVT.

KW - Anticoagulation therapy

KW - Hypercoagulable disorders

KW - Liver cirrhosis

KW - Liver transplant

KW - Portal vein thrombosis (PVT)

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U2 - 10.1007/s10620-012-2548-y

DO - 10.1007/s10620-012-2548-y

M3 - Article

C2 - 23314858

AN - SCOPUS:84879503103

VL - 58

SP - 1776

EP - 1780

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

SN - 0163-2116

IS - 6

ER -