title: Anticoagulant therapy and Budd-Chiari syndrome: is it successful?
abstract: OBJECTIVE
  Anticoagulant therapy is an accepted treatment for Budd-Chiari syndrome (BCS). However, the natural course of untreated patients is unclear. We aimed to evaluate the efficacy of anticoagulant therapy on survival in BCS.
  
  
  METHODS
  Between 1995 and 2007, 45 patients diagnosed with BCS based on the clinical, biochemical, radiological and histological findings were retrospectively evaluated with respect to underlying disease, therapeutic interventions, complications and overall outcome. Complications and survival during the follow-up period were compared in between anticoagulant treated and untreated cases.
  
  
  RESULTS
  Mean patient age was 34.4 +/- 11.8 years and 46.7% (21) of them were male. Median followup time was 24 months (6-132); 8.9% of patients were diagnosed as acute, 31.1% as subacute and 60% as chronic BCS according to disease duration. Centrilobular necrosis was found in 16 of 36 biopsy performed patients. Etiological factors were detected in 60% of patients and 40% of them were cryptogenic. Twenty four of them received anticoagulant therapy, the remaining 21 were followed-up with supportive medical therapy. Five patients who had shunt operation were excluded for survival analyses. Complications were similar between treated and untreated cases (p>0.05). There was a positive correlation between survival and centrilobular necrosis (r=0.376, p=0.037). The mean survival periods were 95.5 months (%95 CI 73-117 months) and 72.5 months (%95 CI 42-103 months) in anticoagulant treated and untreated patients, respectively (p>0.246).
  
  
  CONCLUSIONS
  Most patients with BCS are admitted to hospital at the chronic stage and more than half of them have underlying thrombotic risk factor. In our study, no beneficial effects of anticoagulant therapy were observed on the survival and complications of liver disease.
authors.affiliation: Department of Gastroenterohepatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. filizakyuz@hotmail.com
authors.forename: Filiz
authors.initials: F
authors.lastname: Akyüz
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Cakaloğlu
authors.forename: Binnur
authors.initials: B
authors.lastname: Pinarbaşi
authors.forename: Kadir
authors.initials: K
authors.lastname: Demir
authors.forename: Umit
authors.initials: U
authors.lastname: Akyüz
authors.forename: Sadakat
authors.initials: S
authors.lastname: Ozdil
authors.forename: Fatih
authors.initials: F
authors.lastname: Beşişik
authors.forename: Güngör
authors.initials: G
authors.lastname: Boztaş
authors.forename: Zeynel
authors.initials: Z
authors.lastname: Mungan
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Kaymakoğlu
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D006502:Budd-Chiari Syndrome / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000925:Anticoagulants