• Jianchun Xian, Yongzhi Tang, Hui Shao, Xuequan Wang, Meixian Zhang, and Tongjing Xing.
• Department of Infectious Diseases, Taizhou People's Hospital, Taizhou, Jiangsu Province.
• Medicine (Baltimore). 2021 Apr 23; 100 (16): e25439.

BackgroundPortal vein thrombosis (PVT) is a relatively common complication of cirrhosis. However, the effect of PVT on the prognosis might not be unequivocal. A systematic review and meta-analysis were performed to investigate the effect of PVT on the prognosis of patients with cirrhosis who have not received a liver transplant.MethodsThree databases, including PubMed, EMBASE, and Cochrane Library, were searched for studies published up to March 2020. The survival or mortality rate of patients with PVT served as the main index to evaluate the prognosis of these patients. Hepatic decompensation served as the index of disease progression. Meta-analyses were conducted using Review Manager software 5.2.ResultsSixteen clinical studies were included and analyzed. PVT was associated with an increased risk of mortality in patients with decompensated cirrhosis. According to the meta-analysis, patients with cirrhosis presenting with PVT had a lower 1-year survival rate than patients without PVT (odds ratio (OR), 0.32; 95% confidence interval (CI), 0.14-0.75; P = .008). The cumulative survival rates were similar between the 2 groups at 3 years (OR, 1.04; 95% CI, 1.00-1.08; P = .06), 5 years (OR, 1.33; 95% CI, 0.71-2.48; P = .38) and 10 years (OR, 1.24; 95% CI, 0.79-1.93; P = .35). PVT was associated with a higher mortality rate in patients with Child-Pugh class B and C disease. A significantly increased risk of death was observed in patients with complete PVT. Patients with both PVT and cirrhosis had a higher rate of decompensation than patients without PVT.ConclusionsThe presence of PVT might exert a slight effect on the overall prognosis of patients with cirrhosis. PVT might mainly affect the short-term prognosis by increasing hepatic decompensation events in patients with cirrhosis. However, PVT might not influence the long-term prognosis of patients with cirrhosis.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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