title: Natural course of nonmalignant partial portal vein thrombosis in cirrhotic patients.
abstract: OBJECTIVE
  Portal vein thrombosis (PVT) has a high incidence in patients with liver cirrhosis and determines a poor prognosis of hepatic disease. The aim of our study was to define the natural course of partial PVT in cirrhotic patients, including survival and decompensation rates.
  
  
  METHODS
  We performed a prospective, cohort study, in a tertiary referral center. There were 22 cirrhotic patients with partial nonmalignant PVT, without anticoagulant treatment, who were followed-up between January 2011 and October 2013. All patients were evaluated by Doppler abdominal ultrasound and computed tomography. Kaplan-Meier method was used to determine the difference in clinical events between the study subgroups.
  
  
  RESULTS
  After a mean follow-up period of 20.22 months, partial PVT improved in 5 (22.73%), was stable in 11 (50%), and worsened in 6 (27.27%) patients. Hepatic decompensation rate at 6 and 18 months was higher in patients with worsened PVT than in those with stable/improved PVT (50% vs. 25%, P < 0.0001 and 100% vs. 56.25%, P < 0.0001, respectively). The survival rate at 6 months was 66.66% in worsened PVT group vs. 81.25% (P = 0.005) in stable/improved group, and 16.66% vs. 81.25% (P < 0.0001) at 18 months, respectively. Multivariate analysis showed that Model of End-Life Disease was the independent predictor of hepatic decompensation [hazard ratio (HR) 1.42; 95% confidence interval (CI): 1.08-1.87, P = 0.012] and survival (HR 1.76; 95% CI: 1.06-2.92, P = 0.028).
  
  
  CONCLUSIONS
  Nonmalignant partial PVT remained stable/improved in over half of cirrhotic patients and aggravated in more than one fourth in whom it negatively influenced the survival and decompensation rates.
authors.forename: Irina
authors.initials: I
authors.lastname: Girleanu
authors.affiliation: Institute of Gastroenterology and Hepatology, "St Spiridon" Emergency Hospital, Iasi, Romania.
authors.forename: Carol
authors.initials: C
authors.lastname: Stanciu
authors.forename: Camelia
authors.initials: C
authors.lastname: Cojocariu
authors.forename: Lucian
authors.initials: L
authors.lastname: Boiculese
authors.forename: Ana-Maria
authors.initials: AM
authors.lastname: Singeap
authors.forename: Anca
authors.initials: A
authors.lastname: Trifan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003952:Diagnostic Imaging; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011446:Prospective Studies; D015996:Survival Rate; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology*