Portal Vein Thrombosis in Cirrhosis: A Marker of Higher Short-Term Mortality: Liver Transplantation | September 2026

What Did the Study Find?

The multinational CLEARED Consortium prospectively evaluated 7,721 non-electively hospitalised patients with cirrhosis, providing large-scale global data on portal vein thrombosis (PVT).

• PVT was present in 10% of hospitalised patients—approximately 1 in 10.
• Prevalence was higher with MASH/cryptogenic (11.9%) and viral cirrhosis (11.7%) than alcohol-related cirrhosis (7.3%).
• MASH/cryptogenic disease independently increased the odds of PVT (OR 1.59).
• PVT was also associated with previous portal hypertension complications, including ascites, variceal bleeding, overt HE and hydrothorax.
• Patients with PVT experienced more AKI, grade 3–4 HE, 30-day readmissions and liver transplantation.
• 30-day mortality was 22.1% with PVT vs 18.0% without PVT.
• PVT remained independently associated with mortality after adjustment (OR 1.5).

Why Does It Matter?

PVT in hospitalised cirrhosis should not be viewed merely as an incidental radiological finding. It identifies a population with greater portal-hypertension burden and worse early outcomes.

GastroAGI Takeaway

In hospitalised cirrhosis, PVT is an important short-term prognostic marker. Its presence should prompt recognition of a higher-risk clinical phenotype, with careful management of decompensation and closer post-discharge follow-up. Importantly, this observational study establishes a prognostic association—not that PVT itself causes the excess mortality or that routine anticoagulation would reduce it.