Portal vein thrombosis is not associated with increased mortality among patients with cirrhosis.
Clin Gastroenterol Hepatol. 2014 Oct 18;
Authors: Berry K, Taylor J, Liou IW, Ioannou GN
Abstract
BACKGROUND AND AIMS: Portal vein thrombosis (PVT) is common in patients with cirrhosis and may have adverse clinical consequences. We investigated whether PVT is associated with survival in patients with cirrhosis.
METHODS: Using the United Network for Organ Sharing registries from 2002 through 2013, we followed a cohort of transplant-naïve adults with cirrhosis without hepatocellular carcinoma (n=66,506) from the time of transplant listing until the time of liver transplantation or death before transplantation. We used Cox proportional hazards analysis and competing risks analysis to compare patients who had PVT at the time of listing (n=2207) with those who did not (n=64,299) with regards to the risk of transplantation or death before transplantation, after adjusting for important baseline characteristics.
RESULTS: During a mean follow-up of 1.78 years, 17,757 patients (27%) died before liver transplantation, 29,179 (44%) underwent transplantation, and 19,570 (29%) were still alive without having undergone transplantation. Compared to patients who did not have PVT, those with PVT had lower mortality (adjusted hazard ratio [AHR] 0.88; 95% confidence interval [CI] 0.81-0.96), similar risk of transplantation (AHR 0.95; 95% CI 0.89-1.02), and lower risk of the combined outcome of death or transplantation (AHR 0.92; 95% CI 0.88-0.97). Similar results were found by competing risks analyses. Independent predictors of mortality included age, model for end-stage liver disease (MELD) score, serum albumin level, ascites, encephalopathy, diabetes, hepatitis C virus infection and low body mass index (< 24.4 Kg/m(2)).
CONCLUSIONS: Among patients with cirrhosis on liver transplant waiting lists, those with PVT have lower mortality than those without PVT.
PMID: 25459555 [PubMed - as supplied by publisher]