title: Impact of untreated portal vein thrombosis on pre and post liver transplant outcomes in cirrhosis.
abstract: OBJECTIVE
  Most portal vein thromboses (PVT) in cirrhotics are discovered incidentally. While case series demonstrate improved portal vein patency with anti-coagulation, there is little information on impact of PVT on morbidity and mortality. This study aimed to compare morbidity and mortality in cirrhotics with untreated PVT with those without PVT.
  
  
  METHODS
  Cirrhotics evaluated for orthotopic liver transplant in a single large transplant center were prospectively followed. Subjects had contrast CT or MRI at initial evaluation and serial imaging every 6 months until transplantation, removal from the list or death. Univariate and multivariate Cox regression analysis were used to assess associations between new PVT and factors of interest.
  
  
  RESULTS
  Of the 290 prospectively followed cirrhotics who met inclusion criteria, PVT was detected in 70 (24.1%)-47 had PVT at the time of initial evaluation and 23 developed one during the pre-transplant study period. A third of the patients with PVT had re-canalization or spontaneous resolution of thrombus while awaiting transplantation. There was no difference in the pre or posttransplant mortality between cirrhotics with and without PVT.
  
  
  CONCLUSIONS
  Cirrhotics with untreated PVT fared equally well as those without PVT before and after transplantation. Further studies with larger numbers of patients are needed to determine if anticoagulation therapy truly improves outcomes in cirrhotics with portal vein thrombosis.
authors.affiliation: Department of Gastroenterology and Hepatology Cleveland Clinic, Cleveland, OH, USA.
authors.forename: B V
authors.initials: BV
authors.lastname: John
authors.forename: R
authors.initials: R
authors.lastname: Konjeti
authors.forename: A
authors.initials: A
authors.lastname: Aggarwal
authors.forename: R
authors.initials: R
authors.lastname: Lopez
authors.forename: A
authors.initials: A
authors.lastname: Atreja
authors.forename: C
authors.initials: C
authors.lastname: Miller
authors.forename: N N
authors.initials: NN
authors.lastname: Zein
authors.forename: W D
authors.initials: WD
authors.lastname: Carey
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009820:Ohio / Q000453:epidemiology; D010690:Phlebography / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012075:Remission, Spontaneous; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D014850:Waiting Lists