PB0966 - Potential utility of a multi-component coagulation factor panel to detect portal vein thrombosis and assess hemostasis in chronic liver disease

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Co-Author(s)

CL

Clayton S. Lewis, PhD

Postdoctoral Fellow
Division of Hematology/Oncology, Department of Internal Medicine, University of Cincinnati College of Medicine
Cincinnati, Ohio, United States
KB

Khurram Bari, MD

Assistant Professor of Medicine
Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine
Cincinnati, Ohio, United States
CX

Changchun Xie, PhD

Professor
Department of Environmental & Public Health Sciences, University of Cincinnati College of Medicine
Cincinnati, Ohio, United States
KS

Kenneth E. Sherman, MD, PhD

Division Chief; Robert and Helen Gould Endowed Professorship
Division of Digestive Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine
Cincinnati, Ohio, United States
MV

Marc Vasse, MD

Professor
Foch Hospital
Suresnes, Ile-de-France, France
PV

Patrick Van Dreden

PhD clinical research manager
Clinical Research Department, Diagnostica Stago
Gennevilliers, Ile-de-France, France

Presenting Author(s)

Vladimir Y. Bogdanov, PhD

Associate Professor of Medicine
College of Medicine, University of Cincinnati
Cincinnati, Ohio, United States

Background: Portal vein thrombosis (PVT) prior to liver transplant (LT) is a major contributor to morbidity, but the means of detecting and/or predicting PVT are limited.

Aims: To explore whether plasma coagulation factor activity levels can help detect and/or evaluate risk for PVT in subjects with chronic liver disease (CLD) awaiting LT.

Methods: Informed consent was obtained from each subject; study was approved by institutional review boards. Circulating levels of Factor V (FV), Factor VIII (FVIII), Protein C (PC), and Protein S (PS) activity levels and the concentrations of D-dimer, sP-selectin, and alternatively spliced tissue factor (asTF) were assessed in two CLD cohorts with severity scored using the Child-Turcotte-Pugh (CTP) formula [ambulatory, n=42 (CTP-A, n=12; CTP-B, n=19; CTP-C, n=11) and LT, n=43 (CTP-A, n=12; CTP-B, n=28; CTP-C, n=3)]. There were no cases of PVT in the ambulatory cohort, and 4 cases of confirmed PVT in the LT cohort.

Results: A strong inverse correlation between FV and FVIII activity levels and the presence of PVT was found in the LT cohort (p=0.030 and p=0.016, respectively). This enabled us to develop a logistic regression-based compensation score (CS) to identify LT patients at risk of PVT.

CS = -7.17 × ln(FV%) - 3.73 × ln(FVIII%) + 47

When FV and FVIII values were subject-matched and graphed as a correlation plot, the four subjects with PVT clustered in the extreme bottom left quadrant (Figure); 2 subjects with PVT had a CS>4.0 and the other two had CS in the 0-4 range. CS values in all subjects without PVT were below 0.

Conclusion(s):

Conclusion: We demonstrate for the first time the feasibility of using a combination of FV and FVIII plasma activity levels to identify CLD coagulopathy associated with high risk of PVT. Larger studies are warranted to validate our findings.