{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:14:41Z","timestamp":1787015681875,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,3,31]],"date-time":"2016-03-31T00:00:00Z","timestamp":1459382400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Italian Ministry of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2016,9]]},"abstract":"Abstract<\/jats:title>\n \n Background & Aims<\/jats:title>\n \n Portal vein thrombosis (\n PVT<\/jats:styled-content>\n ) is frequently observed in cirrhosis and may be a clinically important complication.\n In vitro<\/jats:italic>\n assays for endogenous thrombin potential (\n ETP<\/jats:styled-content>\n ) demonstrated that in cirrhosis plasma has intrinsic resistance to the anticoagulant action of thrombomodulin (\n TM<\/jats:styled-content>\n \u2010\n R<\/jats:styled-content>\n ). This study retrospectively explores the association of\n TM<\/jats:styled-content>\n \u2010\n R<\/jats:styled-content>\n with\n de novo<\/jats:italic>\n PVT<\/jats:styled-content>\n and its clinical impact on cirrhosis.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Fifty\u2010three patients with cirrhosis were tested for\n ETP<\/jats:styled-content>\n \u2010ratio with\/without thrombomodulin. Clinical, endoscopic variables, presence\/absence of\n PVT<\/jats:styled-content>\n by Doppler\u2010\n US<\/jats:styled-content>\n and\/or\n CT<\/jats:styled-content>\n examination were collected at baseline and up to 4 years from baseline. The\n de novo<\/jats:italic>\n PVT<\/jats:styled-content>\n was the primary clinical end\u2010point. Portal hypertension (\n PHT<\/jats:styled-content>\n )\u2010related complications and transplantation free survival were secondary end\u2010points.\n ETP<\/jats:styled-content>\n \u2010ratio higher than the 95\u00b0 percentile of the distribution in 173 healthy controls defined\n TM<\/jats:styled-content>\n \u2010\n R<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During 48 months of follow\u2010up, 11 patients developed\n de novo<\/jats:italic>\n PVT<\/jats:styled-content>\n , with preference for the 36 patients with\n TM<\/jats:styled-content>\n \u2010\n R<\/jats:styled-content>\n after adjusting for Child\u2013Pugh class (HR: 8.354; 90%CI:1.475 \u2010 47.305;\n P<\/jats:italic>\n = 0.009). Seventeen patients experienced\n PHT<\/jats:styled-content>\n \u2010related complications, 23 either died or underwent liver transplantation.\n PHT<\/jats:styled-content>\n complications and transplantation free survival were associated with\n TM<\/jats:styled-content>\n \u2010\n R<\/jats:styled-content>\n , but were independently predicted by Child\u2013Pugh class, only. Same results were obtained by considering the\n MELD<\/jats:styled-content>\n score.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Owing to\n PVT<\/jats:styled-content>\n results from the pro\u2010coagulant imbalance occurring in patients with advanced cirrhosis,\n TM<\/jats:styled-content>\n \u2010\n R<\/jats:styled-content>\n might serve as a predictor and could possibly be a biological mediator of adverse outcome in patients with advanced cirrhosis.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/liv.13087","type":"journal-article","created":{"date-parts":[[2016,2,8]],"date-time":"2016-02-08T06:44:29Z","timestamp":1454913869000},"page":"1322-1330","source":"Crossref","is-referenced-by-count":62,"title":["Resistance to thrombomodulin is associated with\n de novo<\/i>\n portal vein thrombosis and low survival in patients with cirrhosis"],"prefix":"10.1111","volume":"36","author":[{"given":"Vincenzo","family":"La Mura","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology IRCCS Ca\u2019 Granda Maggiore Hospital Foundation University of Milan Milan Italy"},{"name":"Internal Medicine IRCCS San Donato Department of Biomedical Sciences for Health University of Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Tripodi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health Angelo Bianchi Bonomi Hemophilia and Thrombosis Center IRCCS Ca\u2019 Granda Maggiore Hospital Foundation University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Tosetti","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology IRCCS Ca\u2019 Granda Maggiore Hospital Foundation University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flaminia","family":"Cavallaro","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology IRCCS Ca\u2019 Granda Maggiore Hospital Foundation University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veena","family":"Chantarangkul","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health Angelo Bianchi Bonomi Hemophilia and Thrombosis Center IRCCS Ca\u2019 Granda Maggiore Hospital Foundation University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Colombo","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology IRCCS Ca\u2019 Granda Maggiore Hospital Foundation University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Primignani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology IRCCS Ca\u2019 Granda Maggiore Hospital Foundation University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,3,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(85)90327-0"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2004.01.001"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04182.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.042796"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011170"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.08.045"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.06.008"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.07.018"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.09.020"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.03.036"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000071636"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23653"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2013.258"},{"key":"e_1_2_8_15_1","first-page":"547","article-title":"Thrombin generation assessed as endogenous thrombin potential (ETP) in patients with hypo\u2010 or hyper\u2010coagulability. 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