ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2019
Distinguishing Tumor From Bland Portal Vein Thrombus in Liver Transplant Candidates With Hepatocellular Carcinoma: the A-VENA Criteria.
Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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36 citing papers in PubMed, 70 citations in OpenAlex.
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- The disguised liver abscess closely resembled diffuse hepatocellular carcinoma with portal vein tumor thrombus: a case description and literature analysis.Quantitative imaging in medicine and surgery · 2026Article
- Dual-layer spectral detector computed tomography in distinguishing between bland and neoplastic portal vein thrombosis.Quantitative imaging in medicine and surgery · 2025Article
- Non-tumoral portal vein thrombosis in liver transplantation: Surgical perspectives and institutional protocol.World journal of gastrointestinal surgery · 2025Review
- Correlation between virological response and portal vein thrombosis in patients with chronic hepatitis B.Scientific reports · 2025Article
- Large tumor thrombus extending into the right atrium through the inferior vena cava due to hepatocellular carcinoma: A case report.Radiology case reports · 2025Article
- Disadvantage of Viable Portal Vein Tumor Thrombosis in Liver Transplantation for Advanced Hepatocellular Carcinoma.Cancers · 2025Article
- Management strategies for advanced hepatocellular carcinoma with portal vein tumor thrombosis.Ewha medical journal · 2025Review
- Review
- Portal vein tumor thrombosis in hepatocellular carcinoma patients: Is it the end?Liver research (Beijing, China) · 2024Review
- The clinical outcomes of patients with vascular invasion after deceased donor liver transplantation.Journal of gastrointestinal oncology · 2024Article
- Prevalence and Risk Factors for Portal Cavernoma in Adult Patients with Portal Vein Thrombosis.Diagnostics (Basel, Switzerland) · 2024Article
- Development of a Novel Comprehensive Hepatocellular Carcinoma Outcome Prognostic Scoring System With Integration of Imaging Features.The oncologist · 2024Article
- Portal Vein Thrombosis: State-of-the-Art Review.Journal of clinical medicine · 2024Review
- Cardiovascular adverse events in patients with hepatocellular carcinoma receiving vascular endothelial growth factor inhibitors.Pharmacotherapy · 2024Article
- Systemic Thrombolysis for Isolated Splenic Vein Thrombosis Secondary to Oral Contraceptives: A Case Report.International journal of women's health · 2024Article
- Understanding the role of radiologists in complex treatment decisions for patients with hepatocellular carcinoma.Abdominal radiology (New York) · 2023Review
- Proton beam therapy for downstaging hepatocellular carcinoma with lobar portal vein tumor thrombosis to living donor liver transplantation.Hepatobiliary surgery and nutrition · 2023Article
- Natural History and Outcomes of Cavernous Transformation of the Portal Vein in Cirrhosis.Digestive diseases and sciences · 2023Article
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6 authors at 1 institution in 1 country.
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Abstract
Differentiating tumor versus bland portal vein thrombosis (PVT) is essential in determining liver transplantation (LT) candidacy for patients with hepatocellular carcinoma (HCC). We aimed to evaluate radiographic and clinical features that could noninvasively distinguish tumor PVT from bland PVT in HCC patients. Of 467 patients with HCC listed for LT from 2004 to 2011, 59 (12.6%) had PVT and 12 of 59 (20.3%) were deemed malignant. When comparing tumor versus bland PVT, thrombus enhancement was seen in 100% versus 8.5%; venous expansion was seen in 91.7% versus 10.6%; neovascularity was seen in 58.3% versus 2.1%; and being adjacent to HCC or prior treatment site was seen in 100% versus 21.3% (all P < 0.001). Combining these 4 imaging characteristics with alpha-fetoprotein (AFP) >1000 ng/dL, the presence of ≥3 criteria best characterized tumor PVT with 100% sensitivity, 93.6% specificity, 80% positive predictive value, and 100% negative predictive value. No LT recipients with presumed bland PVT had macrovascular invasion on explant. There were no differences in post-LT survival or HCC recurrence with bland PVT versus no PVT. In conclusion, we proposed noninvasive criteria that could accurately differentiate tumor PVT from bland PVT called A-VENA, which is based on the presence of ≥3 of the following: AFP >1000 ng/dL; venous expansion; thrombus enhancement; neovascularity; and adjacent to HCC. Use of the A-VENA criteria can assist in standardizing the evaluation of PVT in patients with HCC being considered for LT.
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