ArticleHepatology international2023
Von Willebrand factor processing in patients with advanced chronic liver disease and its relation to portal hypertension and clinical outcome.
Article in Hepatology international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03267615 (VICIS - Vienna Cirrhosis Study), which is not on this map. Cited by 20 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
VICIS - Vienna Cirrhosis Study
Who cites it
20 citing papers in PubMed, 19 citations in OpenAlex.
- Circulating fibronectin levels are linked to liver function, matrix remodeling, and hemostatic complications in advanced chronic liver disease.Hepatology international · 2026Article
- First decompensation outweighs portal vein thrombosis in cACLD: Molecular profiling and derivation of the VAIL score.JHEP reports : innovation in hepatology · 2026Article
- Post-TIPS Dynamics of von Willebrand Factor for Risk Stratification After TIPS Placement.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
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- Liver sinusoidal endothelial cell fenestrations in metabolic liver disease: from molecular mechanisms to therapeutic perspectives.Cell communication and signaling : CCS · 2026Review
- Renal Impairment as an Independent Predictor of Sepsis in Cirrhosis: A Retrospective Cohort Study.Microorganisms · 2026Article
- Article
- Noninvasive multimodal management of portal hypertension: from early screening to precision clinical decision-making.Translational gastroenterology and hepatology · 2026Review
- Total thrombus formation system exploration of primary hemostasis in cirrhotic patients.Research and practice in thrombosis and haemostasis · 2026Article
- Clinical and pathophysiological perspectives on haemostasis, inflammation, and thrombo-haemorrhagic risk in cirrhosis.EXCLI journal · 2026Review
- Plasmin-mediated proteolysis of von Willebrand factor in patients with acute and chronic liver disease.Research and practice in thrombosis and haemostasis · 2025Article
- Nomogram model for identifying portal vein thrombosis in patients with decompensated cirrhosis.European journal of gastroenterology & hepatology · 2025Article
- Non-invasive assessment of portal hypertension: Liver stiffness and beyond.JHEP reports : innovation in hepatology · 2025Review
- Review
- Von Willebrand Factor Antigen, Biomarkers of Inflammation, and Microvascular Flap Thrombosis in Reconstructive Surgery.Journal of clinical medicine · 2024Article
- Enhanced liver fibrosis (ELF) score predicts hepatic decompensation and mortality.JHEP reports : innovation in hepatology · 2024Article
- Thrombotic Thrombocytopenic Purpura in the Setting of Cirrhosis and Baseline Thrombocytopenia.Cureus · 2024Article
- Non-cirrhotic intrahepatic portal hypertension: Is the gun loaded?Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2024Article
- VWF/ADAMTS13 Ratio as a Potential Predictive Biomarker for Acute Kidney Injury Onset in Cirrhosis.Digestive diseases and sciences · 2024Article
- ADAMTS-13: A Prognostic Biomarker for Portal Vein Thrombosis in Japanese Patients with Liver Cirrhosis.International journal of molecular sciences · 2024Article
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Authors and funding
15 authors at 5 institutions in 3 countries.
Funding
Abstract
BACKGROUND AND
aimsEndothelial dysfunction and portal hypertension (PH) are reflected by increased von Willebrand factor antigen (VWF-Ag) levels in advanced chronic liver disease (ACLD). This study investigated VWF release and cleavage and their association with PH and clinical outcomes.
methodsLevels of VWF-Ag, VWF-N (VWF-propeptide), and VWF-A (VWF processed by the main VWF-cleaving protease ADAMTS13) were assessed in 229 patients with clinically stable ACLD (hepatic venous pressure gradient [HVPG] ≥ 6 mmHg; absence of bacterial infections or acute decompensation) undergoing HVPG-measurement. Liver-healthy individuals served as controls (n = 24).
resultsVWF-Ag and VWF-N were similarly accurate for the identification of clinically significant PH (CSPH; HVPG ≥ 10 mmHg) in compensated ACLD (AUROC: VWF-Ag 0.748; VWF-N 0.728). ADAMTS13 activity was similar between patients with ACLD and controls and did not correlate with PH and disease severity, whereas VWF cleavage decreased in patients with CSPH (i.e., VWF-Ag/-A-ratio increased). In vitro VWF activity strongly reflected VWF-Ag levels (Spearman's r = 0.874, p < 0.001), but decreased (vs. controls) in patients with CSPH when normalized to VWF-Ag levels (VWF-activity/-Ag-ratio). VWF-Act/-Ag ratio correlated negatively with ADAMTS13 activity (r =- 0.256, p < 0.001). ADAMTS13 activity was independently predictive for (i) portal vein thrombosis (PVT) and (ii) hepatic decompensation or liver-related death.
conclusionsVWF-Ag levels and its propeptide are similarly suitable surrogates of PH in patients with compensated ACLD. ADAMTS13-Act was not linked to disease and PH severity, however, when normalized to VWF-Ag, both VWF cleavage and VWF activity were decreased in patients with CSPH, as compared to liver-healthy individuals. Low ADAMTS13-Act was associated with presumably more procoagulant VWF and adverse outcomes. CLINICAL TRIAL NUMBER: NCT03267615.
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