Assessing Risk of Developing Portal Vein Clots in People Awaiting Liver Transplantation
New scoring tool predicts development of blood clots in portal vein
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American Association for the Study of Liver Diseases (AASLD)Nov 11, 2016, 08:00 ET
BOSTON, Nov. 11, 2016 /PRNewswire/ -- A new scoring tool has been developed to assess the risk of developing a blood clot in the vein that brings blood from the intestines to the liver (portal vein) among people awaiting liver transplantation, according to research presented this week at The Liver Meeting® — held by the American Association for the Study of Liver Diseases.
Portal vein thrombosis (PVT) in people with cirrhosis (scaring of the liver) can lead to worsening of liver disease, poorer outcomes and can potentially cause patients to be unable to receive a liver transplantation. Prevalence of PVT in patients undergoing, or under evaluation for, liver transplantation is five to 16 percent, and researchers from the Intermountain Medical Center in Murray, UT have developed a tool to assess the risk of patients with cirrhosis developing this complication.
Dr. Charlton's team looked at the medical records of 621 patients on liver transplantation waiting list between December 1987 and May 2014. Patients were randomly divided into two groups: 70 percent were placed into group A (derivation group) and 30 percent into group B (validation group). The researchers looked at several risk factors in group A and found that presence of liver disease associated confusion, bacterial peritonitis, dilated veins in the esophagus or stomach, and a serum bilirubin level greater than 4.5 mg/dL showed association with developing PVT; using these factors a risk score was developed and tested on group B.
A total of 63 patients developed PVT while awaiting liver transplantation. Using the risk factors in the study group, Dr. Charlton's team developed a PVT risk score with a maximum score of 5. A score of greater than three carried a hazard ratio of 15 for developing PVT.
"We hope that these findings will lead to a prospective study to determine if portal vein thromboses can be prevented in patients in the high risk groups," says Michael R. Charlton, MD, FRCP; professor of medicine; medical director of hepatology and liver transplantation; Intermountain Medical Center, Murray, Utah.
Dr. Charlton will present these findings at AASLD's press conference in Room 313 at John B. Hynes Veterans Memorial Convention Center in Boston on Saturday, November 12 at 4pm. The study entitled "A Risk Prediction Model For Portal Vein Thrombosis In Patients Waiting For Liver Transplantation Developed Using Discovery And Validation Cohorts" will be presented by Abdul Haseeb, MD, MPH on Monday, November 14 at 5:30pm in Room 210. The corresponding abstract (number 238) can be found in the journal, Hepatology – Special Issue: The 67th Annual Meeting of the American Association for the Study of Liver Diseases: The Liver Meeting 2016.
About the AASLD
AASLD is a medical subspecialty society representing clinicians and researchers in liver disease. The work of our members has laid the foundation for the development of drugs used to treat patients with viral hepatitis. Access to care and support of liver disease research are at the center of AASLD's advocacy efforts.
AASLD is the leading organization of scientists and healthcare professionals committed to preventing and curing liver disease. AASLD was founded in 1950 by a small group of leading liver specialists and has grown to an international society responsible for all aspects of hepatology.
Press releases and additional information about AASLD are available online at www.aasld.org.
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SOURCE American Association for the Study of Liver Diseases (AASLD)
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