Portal vein thrombosis increases short-term mortality among hospitalized patients with cirrhosis in a global cohort
Liver Transplantation, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/lvt.0000000000000994
- Dergi Adı: Liver Transplantation
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: anticoagulation, CLEARED Consortium, Global study, hospitalised Cirrhosis, non-selective beta blockers, Short-term mortality
- Akdeniz Üniversitesi Adresli: Evet
Özet
Background: Portal vein thrombosis (PVT) in cirrhosis is associated with adverse outcomes, but determinants of PVT and its impact on short-term outcomes in hospitalized patients across global regions remain unclear. Methods: The multinational CLEARED consortium prospectively enrolled adults with cirrhosis admitted non-electively after consent. Patients were followed during hospitalization and 30 days post-discharge. Radiologically diagnosed PVT was analyzed in relation to demography, etiology, clinical features, hospital course, and 30-day outcomes, including mortality. Results: Among 7, 721 patients, etiologies included alcohol related (41.3%), MASH/cryptogenic (24.4%), hepatitis B (19.4%), and hepatitis C (11.3%). PVT was present in 773 patients (10.0%). Prevalence was higher in MASH/cryptogenic and viral cirrhosis compared with alcohol etiology (11.9%, 11.7% vs. 7.3%). Alcohol etiology was associated with lower odds of PVT [OR 0.64 (95% CI 0.5–0.8), p<0.001]. PVT was more common in patients with diabetes (37.4% vs. 28.9%) and in high-income countries (all p<0.001). Independent predictors of PVT included MASH/cryptogenic etiology [OR 1.59 (95% CI 1.2–2.1), p<0.01], prior portal hypertension–related complications (ascites, variceal bleeding, overt HE, hydrothorax), and non-selective beta-blocker use. PVT associated with higher rates of AKI, grade 3–4 hepatic encephalopathy, 30-day readmission, and liver transplantation (all p<0.05). Thirty-day mortality was higher in patients (22.1% vs. 18.0%; p=0.001), and PVT independently predicted mortality (OR 1.5; 95% CI 1.1–1.9; p<0.001). Conclusions: PVT affects one in ten patients in a global inpatient cirrhosis cohort, and independently predicts short-term mortality and major complications, identifying a high-risk subgroup requiring intensified inpatient and post-discharge care.