Development of treatment for intractable portal vein thrombosis targeting intestinal flora-related coagulation disorders

2023 Fiscal Year Final Research Report

• Project/Area Number: 20K08280
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Kanazawa University
• Principal Investigator: Takatori Hajime 金沢大学, 附属病院, 准教授 (60613734)
• Co-Investigator(Kenkyū-buntansha): 飯田 宗穂 金沢大学, 附属病院, 講師 (40705604)
• Project Period (FY): 2020-04-01 – 2024-03-31
• Keywords: 門脈血栓 / 肝硬変

Outline of Final Research Achievements

We collected cases of portal vein thrombosis and found that patients with reduced antithrombotic activity had a poor prognosis, and in particular, that it was a factor related to death from liver failure. In addition, we published a paper in an overseas academic society that showed that in cases of partial splenic artery embolization (PSE) to lower portal vein pressure, which is attracting clinical attention as a salvage treatment for patients with portal hypertension, and in cases of difficulty in controlling anticoagulation treatment for the appearance of portal vein thrombi in splenectomy, symptoms of portal hypertension worsen, leading to increased gastrointestinal bleeding events and further affecting life prognosis. The results of treatment of patients with portal vein thrombosis treated with DOAC, the significant decrease in pre- and post-treatment FDP in successful cases, and the response rate in Yerdel classification 2/3 were presented at an overseas academic conference.

Free Research Field

消化器内科

Academic Significance and Societal Importance of the Research Achievements

門脈血栓症例を集積し、抗凝固療法の有効性および再燃、臨床経過との関連を解析した。アンチトロンビン活性低下は有意に生命予後が不良であり、とくに肝不全死に関わる因子であることを解明し、英文論文として発表した。 また門脈圧亢進症例のサルベージ治療として臨床的に注目されている門脈圧低下目的での部分脾動脈塞栓術（PSE）や脾臓摘出術における門脈血栓の出現に対する抗凝固治療でのコントロール困難例においては門脈圧亢進症状が増悪し、消化管出血イベントの増加、さらに生命予後へ影響することを国内外の学会で発表し、論文化の予定である。