studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 285A
on the underlying mechanisms of action of taurine and further
long-term evaluation in cirrhosis and portal hypertension are
warranted.
Disclosures:
Mattias Mandorfer - Consulting: Janssen; Speaking and Teaching: AbbVie, Gilead,
Janssen, Boehringer Ingelheim, Bristol-Myers Squibb, Roche
Thomas Reiberger - Consulting: Xtuit; Grant/Research Support: Roche, Gilead,
MSD, Phenex; Speaking and Teaching: Roche, Gilead, MSD
Michael Trauner - Advisory Committees or Review Panels: MSD, Janssen, Gilead,
Abbvie; Consulting: Phenex; Grant/Research Support: Intercept, Falk Pharma,
Albireo; Patent Held/Filed: Med Uni Graz (norUDCA); Speaking and Teaching:
Falk Foundation, Roche, Gilead
Markus Peck-Radosavljevic - Advisory Committees or Review Panels: Bayer, Gilead,
Janssen, BMS, AbbVie; Consulting: Bayer, Boehringer-Ingelheim, Jennerex,
Eli Lilly, AbbVie; Grant/Research Support: Bayer, Roche, Gilead, MSD, AbbVie;
Speaking and Teaching: Bayer, Roche, Gilead, MSD, Eli Lilly, AbbVie, Bayer
The following authors have nothing to disclose: Remy Schwarzer, Rafael Paternostro,
Birgit B. Heinisch, Philipp Schwabl, Arnulf Ferlitsch
150
Anticoagulation in patients with cirrhosis and portal
vein thrombosis is associated with increased portal vein
recanalization and better prognosis.
Carlos Noronha Ferreira 1 , Teresa Rodrigues 2 , Ana Júlia Pedro 3 ,
Paula Ferreira 1 , Margarida Sobral Dias 1 , Afonso Gonçalves 4 ,
Leonor Xavier Brito 1 , Fatima Serejo 1 , Rui T. Marinho 1 , Cilénia
B. Costa 1 , Narcisa Fatela 1 , Helena Cortez-Pinto 1 , Fernando
Ramalho 1 , Paula Alexandrino 1 , José F. Velosa 1 ; 1 Serviço de Gastrenterologia
e Hepatologia, Hospital de Santa Maria, Centro
Hospitalar Lisboa Norte, Lisboa, Portugal; 2 Laboratório de Biomatemática,
Faculdade de Medicina de Lisboa, Lisboa, Portugal;
3 Serviço de Medicina 2, Hospital de Santa Maria - Centro Hospitalar
Lisboa Norte, Lisboa, Portugal; 4 Serviço de Imagiologia,
Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisboa,
Portugal
Introduction: Cirrhosis is recognized as a prothrombotic state.
A recent study showed that prophylactic anticoagulation prevented
portal vein thrombosis (PVT) and decreased episodes
of decompensation of cirrhosis. Aims: To analyze the effect
of anticoagulation on recanalization of non-tumoral PVT in
patients with cirrhosis and its effect on prognosis. Methods: 69
consecutive patients with cirrhosis diagnosed with non-tumoral
PVT were studied. The clinical features at diagnosis of PVT and
factors associated with anticoagulation use were studied. Decision
to start anticoagulation was taken at the discretion of the
clinician managing the patient. The effect of anticoagulation
on PVT recanalization and mortality was analyzed. Results:
The average age was 58.6±11.8 years and 44(64%) were
males. Severity of cirrhosis: Median(Range) Child–Pugh(CP)
score: 8(5-15), MELD score:13(6-35). CP class: A-15(22%),
B-32(46%), C-22(32%). At diagnosis of PVT, 55(80%) were
symptomatic. Variceal bleeding(VB) in 30(46%) and abdominal
pain in 19(29%) were the main clinical presentations.
Anticoagulation (LMWH–9, warfarin–16) was administered in
25(36%) patients one of whom with cavernoma. Patients with
VB were less likely to be given anticoagulation (p=0.037).
There were no differences in age, gender, etiology, severity of
cirrhosis and extent of PVT in patients receiving, or not, anticoagulation.
Recanalization of PVT was assessed by at least one
imaging study in 60 patients and recanalization (Total–13, partial
– 9) of the portal vein was documented in 22(37%) patients.
Median (Range) follow–up was 21(0-376) months. At the end
of follow-up, 29(42%) patients died, of which sixteen deaths
were related to infectious complications with no deaths due to
anticoagulation related bleeding. By Cox regression analysis,
factors associated with mortality at the end of follow-up were:
Age (HR 1.040, 95% C.I. 1.002–1.078, p=0.037), CP score
(HR 1.35, 95% C.I. 1.18–1.55, p