Impact of Non-malignant Portal Vein Thrombosis on Outcomes of Liver Cirrhosis

Portal vein thrombosis (PVT) is usually associated with cirrhosis with reduced hepatic reserve. PVT sometimes has a natural history of spontaneous disappearance or shrinkage, but in other cases, PVT volume increases and portal vein blood flow is impaired, which reduces hepatic reserve causing portal hypertension, increased ascites, variceal exacerbation, and bleeding. Prognosis often does not differ between cases with and without PVT. In patients awaiting liver transplantation, the consensus recommendation for PVT is anticoagulant therapy, given that thrombus affects outcome and prognosis post-transplantation. Prophylactic low molecular weight heparin may prevent complicating PVT in patients with cirrhosis and delaying the progression to liver failure. However, it is not clear whether PVT affects prognosis directly. In terms of the effects of PVT on varicose veins (e.g., in the esophagus), variceal bleeding may occur and endoscopic treatment takes time. Thus, prevention and treatment of PVT may improve prognosis in patients with cirrhosis. Large-scale prospective studies of PVT and treatment are needed to clarify the types and effects of PVT on liver cirrhosis prognosis and identify good treatment targets.