Impact of Treatment Response to Anticoagulant Therapy on Liver-Related Events in Patients With Cirrhosis and Portal Vein Thrombosis
Research article published in Hepatology research : the official journal of the Japan Society of Hepatology (2026)
Abstract
AIM: The effect of treatment response to anticoagulant therapy on prognosis of patients with cirrhosis and portal vein thrombosis (PVT) remains unclear. METHODS: Forty-one patients with cirrhosis and first PVT treated with intravenous anticoagulant therapy between January 2015 and April 2018 at 10 Japanese hospitals were included. Treatment response was defined based on change in size of PVT after anticoagulant therapy as the following: complete response (CR, 0%), partial response (PR, ≤ 50%), stable disease (SD, 51%-100%), and progressive disease (PD, ≥ 101%). CR and PR were combined as the effective group and SD and PD formed as the ineffective group. RESULTS: The median age was 69 years, and 56% of the patients had Child-Pugh class B. Overall, 5 (12%) achieved CR, 22 (54%) achieved PR, 12 (29%) had SD and 2 (5%) had PD. During a median follow-up of 31.8 months from the date of assessment of treatment response, 17 patients died. The overall survival rates at 1- and 3-year were 82.5% and 65.1%, respectively. In the multivariate analysis, the model for end-stage liver disease-Na score was significantly associated with overall survival, whereas treatment response was not significant. Twenty-five patients experienced liver-related events with hospitalization, and the 3-year cumulative rate of liver-related events was 63.9%. In the multivariate analysis, treatment response was significantly associated with liver-related events. The 3-year cumulative rates of liver-related events were 56.7% and 75.5% in the effective and ineffective groups, respectively (p = 0.008). CONCLUSIONS: Among patients with cirrhosis, treatment response to anticoagulant therapy for PVT correlated with the incidence of liver-related hospitalization events.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
The effect of treatment response to anticoagulant therapy on prognosis of patients with cirrhosis and portal vein thrombosis (PVT) remains unclear. Forty-one patients with cirrhosis and first PVT treated with intravenous anticoagulant therapy between January 2015 and April 2018 at 10 Japanese hospitals were included.
Why This Matters for Hirudotherapy
This multicenter Japanese study of 41 patients with cirrhosis and a first portal vein thrombosis treated with intravenous anticoagulation graded treatment response by change in thrombus size and found that, while response did not significantly predict overall survival (driven instead by MELD-Na score), an effective anticoagulant response was significantly associated with fewer liver-related hospitalization events (3-year cumulative rate 56.7% in responders vs 75.5% in non-responders, P = 0.008). It is relevant to the hirudotherapy clinical-evidence picture as a real-world look at how successfully dissolving venous thrombus translates into patient-meaningful outcomes in a fragile, bleeding-prone cirrhotic population, the kind of risk-benefit balance any antithrombotic strategy must respect. The caveats are that this is a small observational cohort (41 patients across 10 hospitals) of conventional intravenous anticoagulation, not hirudotherapy, and the survival analysis was underpowered, so the association with liver-related events is hypothesis-generating rather than confirmatory.
Citation
Impact of Treatment Response to Anticoagulant Therapy on Liver-Related Events in Patients With Cirrhosis and Portal Vein Thrombosis.
Maeda A et al. · Hepatology research : the official journal of the Japan Society of Hepatology, 2026
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