Current knowledge and management of portal vein thrombosis in cirrhosis

J Hepatol. 2021 Aug;75(2):442-453. doi: 10.1016/j.jhep.2021.04.029. Epub 2021 Apr 27.


Portal vein thrombosis (PVT) is an increasingly recognised complication of cirrhosis whose incidence increases in parallel with the severity of cirrhosis. Several risk factors have been associated with the occurrence and progression of PVT. Although the negative effect of complete PVT on the surgical outcome of liver transplant recipients is clear, its impact on cirrhosis progression remains uncertain. Treatment options include anticoagulants and interventional thrombolytic therapies, which are chosen almost on a case-by-case basis depending on the characteristics of the patient and the thrombus. In this manuscript, we review current knowledge regarding the epidemiology, risk factors, diagnosis and classification, natural history, clinical consequences and treatment of non-neoplastic PVT in cirrhosis.

Keywords: Cirrhosis; Coagulopathy; Portal hypertension; Portal vein thrombosis; TIPS; Transplant.

Publication types

  • Review

MeSH terms

  • Humans
  • Incidence
  • Liver Cirrhosis / complications*
  • Portal Vein / abnormalities*
  • Portal Vein / diagnostic imaging
  • Risk Factors
  • Venous Thrombosis / classification
  • Venous Thrombosis / etiology*
  • Venous Thrombosis / physiopathology