{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:39:08Z","timestamp":1792276748301,"version":"4.4.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,12,5]],"date-time":"2021-12-05T00:00:00Z","timestamp":1638662400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and Aim<\/jats:title>\n            <jats:p>Portal vein thrombosis (PVT) is a common complication of cirrhosis. The exact pathophysiology remains largely unknown, and treatment with anticoagulants does not lead to recanalization of the portal vein in all patients. A better insight into the structure and composition of portal vein thrombi may assist in developing strategies for the prevention and treatment of PVT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>Sixteen prospectively and 63 retrospectively collected nonmalignant portal vein thrombi from patients with cirrhosis who underwent liver transplantation were included. Histology, immunohistochemistry, and scanning electron microscopy were used to assess structure and composition of the thrombi. Most recent CT scans were reanalyzed for thrombus characteristics. Clinical characteristics were related to histological and radiological findings. All samples showed a thickened, fibrotic tunica intima. Fibrin\u2010rich thrombi were present on top of the fibrotic intima in 9\/16 prospective cases and in 21\/63 retrospective cases. A minority of the fibrotic areas stained focally positive for fibrin\/fibrinogen (16% of cases), von Willebrand factor (VWF; 10%), and CD61 (platelets, 21%), while most of the fibrin\u2010rich areas stained positive for those markers (fibrin\/fibrinogen, 100%; VWF, 77%; CD61, 100%). No associations were found between clinical characteristics including estimated thrombus age and use of anticoagulants and presence of fibrin\u2010rich thrombi.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We demonstrate that PVT in patients with cirrhosis consists of intimal fibrosis with an additional fibrin\u2010rich thrombus in only one\u2010third of cases. We hypothesize that our observations may explain why not all portal vein thrombi in patients with cirrhosis recanalize by anticoagulant therapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.32169","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T12:39:40Z","timestamp":1632487180000},"page":"898-911","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":67,"title":["Nonmalignant portal vein thrombi in patients with cirrhosis consist of intimal fibrosis with or without a fibrin\u2010rich thrombus"],"prefix":"10.1097","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6689-3409","authenticated-orcid":false,"given":"Ellen G.","family":"Driever","sequence":"first","affiliation":[{"name":"Surgical Research Laboratory,Department of Surgery,University Medical Center Groningen,Groningen,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fien A.","family":"von Meijenfeldt","sequence":"additional","affiliation":[{"name":"Surgical Research Laboratory,Department of Surgery,University Medical Center Groningen,Groningen,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle","family":"Adelmeijer","sequence":"additional","affiliation":[{"name":"Surgical Research Laboratory,Department of Surgery,University Medical Center Groningen,Groningen,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbert J.","family":"de Haas","sequence":"additional","affiliation":[{"name":"Department of Radiology,University Medical Center Groningen,Groningen,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius C.","family":"van den Heuvel","sequence":"additional","affiliation":[{"name":"Department of Pathology and Medical Biology,University Medical Center Groningen,Groningen,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrasekaran","family":"Nagasami","sequence":"additional","affiliation":[{"name":"Department of Cell and Developmental Biology,University of Pennsylvania School of Medicine,Philadelphia,Pennsylvania,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Weisel","sequence":"additional","affiliation":[{"name":"Department of Cell and Developmental Biology,University of Pennsylvania School of Medicine,Philadelphia,Pennsylvania,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantino","family":"Fondevila","sequence":"additional","affiliation":[{"name":"Department of Surgery,Hospital Cl\u00ednic,Institute d'Investigacions Biom\u00e8dica Agust\u00ed Pi i Sunyer (IDIBAPS),University of Barcelona,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Porte","sequence":"additional","affiliation":[{"name":"Department of Surgery,Section of Hepatobiliary Surgery and Liver Transplantation,University Medical Center Groningen,Groningen,the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anabel","family":"Blasi","sequence":"additional","affiliation":[{"name":"Anesthesiology Department,Hospital Cl\u00ednic,Institute d'Investigacions Biom\u00e8dica Agust\u00ed Pi i Sunyer (IDIBAPS),University of Barcelona,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Heaton","sequence":"additional","affiliation":[{"name":"Liver Transplant Surgery,Institute of Liver Studies,King's College Hospital,London,UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Gregory","sequence":"additional","affiliation":[{"name":"Department of Radiology,King's College 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