Analysis of Coagulation Characteristics of Portal Venous Blood in Patients with Decompensated Cirrhotic Portal Hypertension.

OBJECTIVE: Coagulopathy is a common complication in patients with decompensated cirrhotic portal hypertension (DCPH), presenting a significant clinical challenge. Nonetheless, there is limited understanding of the coagulation profile of portal venous blood in DCPH patients. The objective of this study was to evaluate the coagulation characteristics of portal venous blood in DCPH patients by collecting blood samples through a transjugular intrahepatic portosystemic shunt (TIPS).

METHODS: A total of 48 DCPH patients were enrolled to measure the activities of pro- and anticoagulant factors in both portal and peripheral venous blood. A correlation analysis between the activities of coagulation factors and the Child-Pugh scores and classes was performed.

RESULTS: Collecting portal venous blood via TIPS achieved a 100% success rate. In portal venous blood, all pro- and anticoagulant factors tested exhibited lower activities. The activity of protein C (PC) was negatively correlated with the Child-Pugh scores, and the activities of FII, FVII, and PC were negatively correlated with the Child-Pugh classes.

CONCLUSIONS: The collection of portal venous blood via TIPS is a safe and feasible method for studying coagulation characteristics in DCPH patients. The parallel reduction of both pro- and anticoagulant factors in DCPH patients results in a rebalanced but fragile coagulation system, which may lead to portal vein hemorrhage and thrombosis. Furthermore, as the Child-Pugh scores or classes increase, the situation will probably get worse due to FII, FVII, and PC deficiencies.