Hepatology research : the official journal of the Japan Society of Hepatology 2017 09 13() doi 10.1111/hepr.12983
To investigate the current status of portal vein thrombosis (PVT) in Japan, the Clinical Research Committee of the Japan Society of Portal Hypertension conducted a questionnaire survey.
A questionnaire survey of 539 cases of PVT over the previous 10 years was conducted at institutions affiliated with the Board of Trustees of the Japan Society of Portal Hypertension.
The most frequent underlying etiology of PVT was liver cirrhosis (LC) in 75.3%. Other causes included inflammatory diseases of the hepatobiliary system and the pancreas, malignant tumors, and hematologic diseases. The most frequent site was the main trunk of the portal vein (MPV) in 70.5%, and complete obstruction of the main trunk of the PV was present in 11.5%. Among the medications for PVT, danaparoid was administered to 45.8%, warfarin to 26.2%, heparin to 17.3%, and anti-thrombin III (AT-III) to 16.9%. Observation of the course was practiced in 22.4%. Factors contributing to therapeutic efficacy were implementation of various medications, thrombi localized to either the right or left portal vein (PV) only, non-complete obstruction of the MPV and liver function of Child-Pugh class A. A survival analysis showed that the prognosis was favorable with PVT disappearance regardless of treatments.
The questionnaire survey showed the current status of PVT in Japan. Any medication should be administered to a patient with PVT when PVT is recognized. It is necessary to compile a large amount of information and reach a consensus on safe and highly effective management of PVT.