{
  "abstract": "Background: In liver cirrhosis, dysregulated hemostasis predisposes patients to both hemorrhagic and thrombotic complications. The portal vein (PV) is a frequent site of thrombosis, but the underlying mechanisms remain incompletely understood. Whether the PV constitutes a locally hypercoagulable environment remains controversial, as previous studies have reported conflicting findings regarding portal venous platelet activation, endothelial dysfunction, and coagulation factor alterations.\n\nMethods: We enrolled 34 patients with liver cirrhosis undergoing transjugular intrahepatic portosystemic shunt (TIPS) implantation. Platelet count, activation, and reactivity were assessed by flow cytometry before and after TIPS, as well as across multiple vascular compartments, including the PV, superior mesenteric vein, hepatic vein, and peripheral vein. In addition, we measured key coagulation factors involved in secondary hemostasis in the indicated vessels.\n\nResults: Platelet counts declined with advancing liver disease, but no changes in platelet activation or reactivity were observed. Despite elevated platelet counts in the PV, we found no evidence of increased platelet activation or reactivity. Moreover, no compartment-specific differences were detected in the selected conventional coagulation parameters assessed, except for lower fibrinogen levels in the PV compared with the hepatic vein. TIPS implantation did not lead to a short-term increase in platelet activation.\n\nConclusions: In this cohort, we found no evidence of increased portal venous platelet activation or reactivity. Apart from lower fibrinogen levels in the PV compared with the hepatic vein, the selected conventional coagulation parameters assessed did not show consistent compartment-specific differences. These findings do not support the concept of a PV-specific hypercoagulable state as assessed by the present platelet activation and reactivity measures and selected coagulation assays. Rather, they suggest that relief of portal hypertension and reduction of venous stasis may be more relevant for thrombosis risk than changes in platelet activation alone.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty at Heinrich Heine University Düsseldorf, Heinrich Heine University, Düsseldorf, Germany",
    "Department of Diagnostic and Interventional Radiology, Faculty of Medicine & Dusseldorf University Hospital, Heinrich Heine University, Düsseldorf, Germany"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Viktoria Möller"
    },
    {
      "affs": [
        0
      ],
      "name": "Anselm Kunstein"
    },
    {
      "affs": [
        0
      ],
      "name": "Christian Weigel"
    },
    {
      "affs": [
        0
      ],
      "name": "Stephanie D. Wolf"
    },
    {
      "affs": [
        0
      ],
      "name": "Alexander Killer"
    },
    {
      "affs": [
        0
      ],
      "name": "Matthias Dille"
    },
    {
      "affs": [
        0
      ],
      "name": "Mihael Vucur"
    },
    {
      "affs": [
        1
      ],
      "name": "Kai Jannusch"
    },
    {
      "affs": [
        1
      ],
      "name": "Eric Tietz"
    },
    {
      "affs": [
        0
      ],
      "name": "Tom Luedde"
    },
    {
      "affs": [
        1
      ],
      "name": "Peter Minko"
    },
    {
      "affs": [
        0
      ],
      "name": "Johannes G. Bode"
    },
    {
      "affs": [
        0
      ],
      "name": "Carolin Angendohr"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6286kaxhkt69y.bib",
  "cited_by": 0,
  "doi": "10.1016/j.rpth.2026.106977",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696348/",
  "id": "6286kaxhkt69y",
  "issns": [
    "2475-0379"
  ],
  "landing_url": "https://doi.org/10.1016/j.rpth.2026.106977",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2721|Liver Disease and Transplantation"
    ]
  ],
  "openalex": "W7214789146",
  "pdf_url": "https://europepmc.org/articles/PMC13696348?pdf=render",
  "pmcid": "PMC13696348",
  "pmid": "42935537",
  "published": "2026-09-29",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/6286kaxhkt69y.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:43Z",
      "native_id": "PMC13696348",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.rpth.2026.106977"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42935537",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42935537"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2721|Liver Disease and Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Reevaluating hypercoagulability in the portal vein and the impact of transjugular intrahepatic portosystemic shunt on platelet activation in cirrhosis",
  "title_text": "Reevaluating hypercoagulability in the portal vein and the impact of transjugular intrahepatic portosystemic shunt on platelet activation in cirrhosis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:42Z",
  "url": "https://research.draconitic.com/paper/6286kaxhkt69y",
  "venue": "Research and Practice in Thrombosis and Haemostasis",
  "versions": []
}