Potential utility of a multi-component coagulation factor panel to calculate MELD scores and assess the risk of portal vein thrombosis in chronic liver disease.
Potential utility of a multi-component coagulation factor panel to calculate MELD scores and assess the risk of portal vein thrombosis in chronic liver disease.
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DOI：
10.1186/s12876-023-02695-6
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发表时间：
2023-03-09
影响因子：
2.4
通讯作者：
Bogdanov, Vladimir Y.
中科院分区：
文献类型：
--
作者：
Lewis, Clayton S.;Bari, Khurram;Xie, Changchun;Sherman, Kenneth E.;Vasse, Marc;Van Dreden, Patrick;Bogdanov, Vladimir Y.
目前评估慢性肝病（CLD）严重程度的定量方法存在局限性。此外，肝移植（LT）前门静脉血栓形成（PVT）是CLD发病的主要原因;检测和/或预测PVT的方法有限。我们试图探索血浆凝血因子活性水平是否可以作为终末期肝病模型（MELD）中凝血酶原时间/国际标准化比值（PT/INR）的替代物，和/或帮助评估PVT的风险。在两个CLD患者队列（非卧床，n = 42; LT，n = 43）中评估asTF。FV和PC活性水平与MELD评分密切相关，这使得基于FV和PC活性与MELD-Na（替代PT/INR）相关性的多重线性回归开发了一种新的评分系统。6个月和1年随访显示，我们的新方法在预测死亡率方面不劣于MELD-Na。在LT队列中发现FVIII活性水平与PVT之间存在显著负相关（p = 0.010）; FV和PS活性水平呈趋势（p = 0.069，p = 0.064）。我们开发了一种基于逻辑回归的补偿评分来识别有PVT风险的患者。我们证明，FV和PC活动水平可用于取代MELD评分中的PT/INR。我们还显示了联合使用FV、FVIII和PS活性水平评估CLD患者PVT风险的可能性。
Current quantitative approaches to assess chronic liver disease (CLD) severity have limitations. Further, portal vein thrombosis (PVT) pre-liver transplant (LT) is a major contributor to morbidity in CLD; the means of detecting and/or predicting PVT are limited. We sought to explore whether plasma coagulation factor activity levels can serve as a substitute for prothrombin time/international normalized ratio (PT/INR) in the Model for End-stage Liver Disease (MELD), and/or help assess the risk of PVT. Plasma activity levels of Factor V (FV), Factor VIII (FVIII), Protein C (PC), and Protein S (PS) and the concentrations of D-dimer, sP-selectin, and asTF were assessed in two cohorts of CLD patients (ambulatory, n = 42; LT, n = 43). FV and PC activity levels strongly correlated with MELD scores, which enabled the development of a novel scoring system based on multiple linear regressions of the correlations of FV and PC activity with MELD-Na that substitutes PT/INR. Six-month and 1-year follow-up revealed that our novel approach was non-inferior to MELD-Na at predicting mortality. A significant inverse correlation between FVIII activity levels and PVT was found in the LT cohort (p = 0.010); FV and PS activity levels were in-trend (p = 0.069, p = 0.064). We developed a logistic regression-based compensation score to identify patients at risk of PVT. We demonstrate that FV and PC activity levels may be used to replace PT/INR in MELD scoring. We also show the potential of using the combination of FV, FVIII, and PS activity levels to assess the risk of PVT in CLD.
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影响因子：
25.7
作者：
Marrone G;Shah VH;Gracia-Sancho J
通讯作者：
Gracia-Sancho J
影响因子：
6.7
作者：
Hollestellel, MJ;Geertzen, HGM;van Mourik, JA
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作者：
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影响因子：
7.6
作者：
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通讯作者：
Ferlitsch, A.
影响因子：
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作者：
Englesbe, Michael J.;Kubus, James;Pelletier, Shawn J.
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Pelletier, Shawn J.