We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Danaparoid sodium-based anticoagulation therapy for portal vein thrombosis in cirrhosis patients.
- Authors
Hayashi, Takehiro; Takatori, Hajime; Horii, Rika; Nio, Kouki; Terashima, Takeshi; Iida, Noriho; Kitahara, Masaaki; Shimakami, Tetsuro; Arai, Kuniaki; Kitamura, Kazuya; Kawaguchi, Kazunori; Yamashita, Taro; Sakai, Yoshio; Yamashita, Tatsuya; Mizukoshi, Eishiro; Honda, Masao; Toyama, Tadashi; Okumura, Kenichiro; Kozaka, Kazuto; Kaneko, Shuichi
- Abstract
<bold>Background: </bold>Portal vein thrombosis (PVT) is a common complication of cirrhosis. However, in patients with PVT and cirrhosis, there is no clear evidence supporting effective treatment modalities. In this study, we examined the effectiveness and safety of anticoagulation therapy using danaparoid sodium for PVT in patients with cirrhosis.<bold>Methods: </bold>This retrospective study assessed 52 cirrhotic patients with PVT treated with danaparoid sodium for 2 weeks between November 2008 and September 2018. The primary outcome measure was the post-treatment status of PVT assessed by reduction in thrombus volume and safety of the therapeutic intervention. PVT status was evaluated with contrast-enhanced computed tomography (CECT). All patients received 1250 units of danaparoid sodium twice daily by intravenous injection for 14 days. Patients on antithrombin III (AT-III) combination therapy were additionally administered 1500 units of AT-III on days 1-5 and days 8-12. Effectiveness was evaluated by CECT from between days 13 and 18. The secondary outcome measure was the prognosis of PVT.<bold>Results: </bold>All patients showed reduction in PVT volume without complications. Return of plasma AT-III level to > 70% during the treatment period contributes to ≥75% reduction of PVT volume. The prognosis in PVT patients depends on hepatic reserve capacity. When limited to Child-Pugh B and C liver cirrhosis patients, a ≥ 75% reduction of PVT volume improved the prognosis.<bold>Conclusions: </bold>Danaparoid sodium-based anticoagulation therapy was effective and safe for PVT in patients with cirrhosis. Return of plasma AT-III level to the normal range during the treatment period contributes to reduction of PVT volume. A reduction of ≥75% in PVT volume may improve the prognosis of Child-Pugh B and C decompensated cirrhosis patients with PVT.
- Subjects
PORTAL vein; ANTITHROMBIN III; CIRRHOSIS of the liver; THROMBOSIS; INTRAVENOUS injections
- Publication
BMC Gastroenterology, 2019, Vol 19, Issue 1, p1
- ISSN
1471-230X
- Publication type
journal article
- DOI
10.1186/s12876-019-1140-8