Portal Thrombosis in Cirrhosis: Role of Thrombophilic Disorders

• Main Authors: José Ignacio Fortea, Inés García Carrera, Ángela Puente, Antonio Cuadrado, Patricia Huelin, Carmen Álvarez Tato, Paloma Álvarez Fernández, María del Rocío Pérez Montes, Javier Nuñez Céspedes, Ana Batlle López, Francisco José González Sanchez, Marcos López Hoyos, Javier Crespo, Emilio Fábrega
• Format: Article
• Language: English
• Published: MDPI AG 2020-08-01
• Series: Journal of Clinical Medicine
• Subjects: liver cirrhosis; portal vein thrombosis; thrombophilia
• Online Access: https://www.mdpi.com/2077-0383/9/9/2822

In patients with liver cirrhosis the contribution of inherited and acquired prothrombotic disorders in the development of non-malignant portal vein thrombosis (PVT) is inconclusive. The purpose of this retrospective study was to examine the prevalence of thrombophilia in this setting at our center from January 2012 to November 2019. Tests included gene mutational analysis for Factor V Leiden, prothrombin G20210A, <i>JAK2</i> (V617F), Calreticulin (<i>CARL</i>), in addition to activated protein C resistance, antithrombin III, protein C and S levels, and antiphospholipid antibodies. We included 77 patients, six of whom (7.8%) had a thrombophilic disorder: antiphospholipid syndrome in four patients, prothrombin gene mutation in one and factor V Leiden mutation in one. This latter patient had also been diagnosed with polycythemia vera years before PVT development. Complete thrombosis of the main portal vein and re-thrombosis after stopping anticoagulation were more frequent in patients with thrombophilia, but the rates of recanalization under anticoagulant therapy were similar among groups. No other difference was accounted between groups. The low prevalence of acquired and inherited thrombophilia found in patients with cirrhosis and PVT support testing for these disorders on an individual basis and avoiding universal screening to reduce costs and unwarranted testing.