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DOI: 10.1055/s-0039-1691902
The impact of ABO blood type on VWF and factor VIII levels and the prevalence of portal vein thrombosis in patients with advanced chronic liver disease
Publication History
Publication Date:
16 May 2019 (online)
Background and aims:
Non-O blood type (BT) is a risk factor for venous and arterial thromboses in the general population, which has been attributed to the effect of non-O-BT von Willebrand factor (VWF) and factor VIII (FVIII) levels. However, although procoagulant alterations, such as high VWF/FVIII levels, have been suggested as a risk factor for portal vein thrombosis (PVT) in patients with advanced chronic liver disease (ACLD), the impact of ABO-BT on PVT is unknown. We aimed to assess (I) whether non-O-BT is a risk factor for PVT and (II) whether non-O-BT impacts VWF/factor VIII levels in patients with ACLD.
Methods:
Retrospective analysis comprising two patient cohorts: (I) 'US' including all adult liver transplantations in the US in the MELD era and (II) 'Vienna' comprising patients with a hepatic venous pressure gradient (HVPG) ≥6 mmHg.
Results:
(I) The 'US' cohort comprised 84947 patients (non-O: 55.43%). The prevalences of PVT at the time of listing for liver transplantation (4.37% vs. 4.56%; P= 0.1762) and at liver transplantation (9.56% vs. 9.33%; P= 0.2546)) were similar in patients with O- and non-O BT.
(II) 411 patients were included in the 'Vienna' cohort (non-O: 64%). Mean HVPG was 18 (9)mmHg and 90% of patients had a HVPG≥10 mmHg. VWF plasma levels were slightly higher in patients with a non-O BG (318 (164)% vs. 309 (176)%; P= 0.048; increase of 23.8 – 23.9% in adjusted analyses), however, ABO blood type explained only 1% of the variation in VWF and had no effect on factor VIII levels.
Conclusions:
ABO blood type contributes to the variation in VWF levels in patients with ACLD, however, its contribution to the variation of VWF is considerably smaller than in liver-healthy subjects. Moreover, ABO blood type had no impact on factor VIII. These findings may explain the absence of an association between ABO blood type and PVT in a large dataset.
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