Stine JG, Argo CK, Pelletier SJ, Maluf DG, Caldwell SH, Northup PG. Advanced non-alcoholic steatohepatitis cirrhosis: A high-risk population for pre-liver transplant portal vein thrombosis. World J Hepatol 2017; 9(3): 139-146 [PMID: 28217250 DOI: 10.4254/wjh.v9.i3.139]
Corresponding Author of This Article
Patrick G Northup, MD, MHS, Division of Gastroenterology and Hepatology, Department of Medicine, Center for the Study of Coagulation Disorders in Liver Disease, University of Virginia, JPA and Lee Street, MSB 2145, PO Box 800708, Charlottesville, VA 22908-0708, United States. northup@virginia.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jan 28, 2017; 9(3): 139-146 Published online Jan 28, 2017. doi: 10.4254/wjh.v9.i3.139
Advanced non-alcoholic steatohepatitis cirrhosis: A high-risk population for pre-liver transplant portal vein thrombosis
Jonathan G Stine, Curtis K Argo, Shawn J Pelletier, Daniel G Maluf, Stephen H Caldwell, Patrick G Northup
Jonathan G Stine, Curtis K Argo, Stephen H Caldwell, Patrick G Northup, Division of Gastroenterology and Hepatology, Department of Medicine, Center for the Study of Coagulation Disorders in Liver Disease, University of Virginia, Charlottesville, VA 22908-0708, United States
Shawn J Pelletier, Daniel G Maluf, Division of Transplant, Department of Surgery, University of Virginia, Charlottesville, VA 22908-0708, United States
Author contributions: Stine JG and Northup PG planned and conducted study, collected and/or interpreted data; Stine JG, Argo CK, Pelletier SJ, Maluf DG, Caldwell SH and Northup PG drafted the manuscript and approved final version.
Institutional review board statement: Institutional review board approval was not required for this study as the UNOS/OPTN dataset is deidentified.
Conflict-of-interest statement: The authors of this manuscript have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Patrick G Northup, MD, MHS, Division of Gastroenterology and Hepatology, Department of Medicine, Center for the Study of Coagulation Disorders in Liver Disease, University of Virginia, JPA and Lee Street, MSB 2145, PO Box 800708, Charlottesville, VA 22908-0708, United States. northup@virginia.edu
Telephone: +1-434-2437741 Fax: +1-434-2447529
Received: April 26, 2016 Peer-review started: April 26, 2016 First decision: July 20, 2016 Revised: October 25, 2016 Accepted: December 13, 2016 Article in press: December 14, 2016 Published online: January 28, 2017 Processing time: 270 Days and 23.9 Hours
Core Tip
Core tip: Non-alcoholic steatohepatitis (NASH) is increasing in prevalence and is expected to be the leading indication for liver transplantation in the foreseeable future. There is a growing body of evidence supporting the clinical importance of a thrombophilic state in patients with NASH. In NASH patients, the most severe hypercoagulable environment is found in patients with NASH cirrhosis. High-risk NASH patients (concomitant age > 60 years, obesity, diabetes and hypertension) have inferior post transplantation outcomes, however, how this group’s risk of clotting compares to other etiologies of liver disease is unknown. In a retrospective nationwide United States based cohort, we provide further evidence of coagulation derangement in NASH and identify a new high-risk subtype in the high-risk NASH population. Whether or not this high-risk group may benefit from preventative anticoagulation remains unknown.
