Anticoagulation in Cirrhosis - IMPORTAL study (Meta-analysis)

10.1016/j.jhep.2023.02.023



  •  Improved Overall survival (HR 0.6) with anticoagulation (VKA) in Cirrhotics, independent of portal vein recanalization rate
  • Portal hypertensive bleeding - same between groups. 
  • Non-PH bleeding: 
  • 80% of patients had main PV thrombus, with half patients had complete PVT
  • Median duration of VKA Rx = 9 months. Overall median FU - 27 months.
  • This was an independent patient level data Meta-analysis of 500 patients, with liver transplantation as competing event. Every study had treatment and no treatment arms.

Exclusions: Tumoral PVT

Limitations: Generally, patients with higher CP scores / bilirubin tended not to receive anticoagulation. This was however adjusted for, in multivariate analysis

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