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.
  
  
  OBJECTIVE
  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.
authors: Division of Gastroenterology and Hepatology, Mayo Clinic, E Mayo Blvd. 5777, Phoenix, AZ 85054, USA.
authors: K T
authors: KT
authors: Werner
authors: Shawna
authors: S
authors: Sando
authors: Elizabeth J
authors: EJ
authors: Carey
authors: Hugo E
authors: HE
authors: Vargas
authors: Thomas J
authors: TJ
authors: Byrne
authors: David D
authors: DD
authors: Douglas
authors: M E
authors: ME
authors: Harrison
authors: Jorge
authors: J
authors: Rakela
authors: Bashar A
authors: BA
authors: Aqel
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D058625:End Stage Liver Disease / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D015995:Prevalence; D012189:Retrospective Studies; D019851:Thrombophilia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D014850:Waiting Lists; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin