• Stefano Lancellotti, Maria Basso, Vito Veca, Monica Sacco, Laura Riccardi, Maurizio Pompili, and Raimondo De Cristofaro.
• Department of Oncology and Haematology, Institute of Internal Medicine and Geriatrics, Center for Hemorrhagic and Thrombotic Diseases and Haemophilia Center, "A. Gemelli" Hospital, Catholic University School of Medicine, Largo A. Gemelli, 00168, Rome, Italy.
• Intern Emerg Med. 2016 Oct 1; 11 (7): 959-67.

AbstractPortal vein thrombosis (PVT) dramatically changes the prognosis of cirrhotic patients, especially those waiting for liver transplantation. However, the possible contribution to PVT of von Willebrand factor (VWF) and ADAMTS-13 is poorly documented. The aim of our study was to assess the presence of alterations of VWF and ADAMTS-13 serum levels in cirrhotic patients with PVT. Twenty-four patients with PVT (group PVT) and 60 without PVT (group without PVT) were enrolled. A comprehensive analysis of biochemical and hemostatic parameters was performed. ADAMTS-13 activity was significantly lower in group A (median 16.8 vs. 69.1 %, p = 0.0047). Group PVT, compared to group without PVT, showed a significantly higher VWF:act, (median 308.4 vs 203.3 %, p = 0.032), whereas no difference was observed for VWF:Ag, FVIII level and the presence of risk factors for venous thromboembolism. No correlation was found between the Child-Pugh score and ADAMTS-13 activity. In multivariable logistic regression analysis performed on data concerning both group PVT and without PVT, only the ADAMTS-13 activity (p = 0.007) was independently and inversely associated with PVT. In conclusion, ADAMTS-13 activity is independently associated with PVT in cirrhotic patients.

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