Portal vein thrombosis and survival in patients with cirrhosis.
The effects of occlusive portal vein thrombosis (PVT) on the survival of patients with cirrhosis are unknown. This was a retrospective cohort study at a single center. The main exposure variable was the presence of occlusive PVT. The primary outcome measure was time-dependent mortality. A total of 3295 patients were analyzed, and 148 (4.5%) had PVT. Variables independently predictive of mortality from the time of liver transplant evaluation included age [hazard ratio (HR), 1.02; 95% confidence interval (CI), 1.01-1.03], Model for End-Stage Liver Disease (MELD) score (HR, 1.10; 95% CI, 1.08-1.11), hepatitis C (HR, 1.44; 95% CI, 1.24-1.68), and PVT (HR, 2.61; 95% CI, 1.97-3.51). Variables independently associated with the risk of mortality from the time of liver transplant listing included age (HR, 1.02; 95% CI, 1.01-1.03), transplantation (HR, 0.65; 95% CI, 0.50-0.81), MELD (HR, 1.08; 95% CI, 1.06-1.10), hepatitis C (HR, 1.50; 95% CI, 1.18-1.90), and PVT (1.99; 95% CI, 1.25-3.16). The presence of occlusive PVT at the time of liver transplantation was associated with an increased risk of death at 30 days (odds ratio, 7.39; 95% CI, 2.39-22.83). In conclusion, patients with cirrhosis complicated by PVT have an increased risk of death.
Englesbe
Michael J
MJ
Division of Transplantation, Department of Surgery, University of Michigan, Ann Arbor, MI, USA. englesbe@med.umich.edu
Kubus
James
J
Muhammad
Wajee
W
Sonnenday
Christopher J
CJ
Welling
Theodore
T
Punch
Jeffrey D
JD
Lynch
Raymond J
RJ
Marrero
Jorge A
JA
Pelletier
Shawn J
SJ
D000328:Adult; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D011169:Portal Vein; D020246:Venous Thrombosis / Q000209:etiology / Q000401:mortality*; D014850:Waiting Lists