Development of portal vein thrombosis: no evidence of endothelial involvement.

Burlage, L. (Laura) (2013) Development of portal vein thrombosis: no evidence of endothelial involvement. thesis, Medicine.

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Abstract

Background: Thrombosis of the portal vein, vena cava inferior and hepatic artery occur under specific circumstances. Vascular endothelium plays an essential role in haemostasis and the relative expression of pro- and anti-coagulant factors differs along vessels. The aim of our research is to investigate whether endothelial changes in the main vessels of the liver contribute to the development of thrombosis of the portal vein, vena cava inferior or hepatic artery. Methods: During 20 orthotopic liver transplantations biopsies of liver macro-vasculature of both patients with cirrhosis and healthy liver donors were collected. Using Real-Time PCR TM- and TF-mRNA expression levels and using immunohistochemistry TM- and TF-protein expression levels were determined. Expression level of endothelial cell-marker vWF was determined on both protein and mRNA level to ensure endothelial presence. Results: In healthy donor liver, both protein and gene expression levels of TM, TF and vWF were not significantly different (p>0,05) between portal vein, vena cava inferior and hepatic artery. In portal vein, gene expression levels of TM, TF and vWF were not significantly different (p>0,05) between cirrhosis and healthy liver. In vena cava inferior, gene expression levels of TM, TF and vWF were also not significantly significantly different (p>0,05) between cirrhosis and healthy liver. In hepatic artery, TM, TF and vWF gene expression levels were significantly higher (p<0,05) in cirrhosis then in healthy liver. Immunohistochemical assessment of anti-vWF antibody and anti-TM antibody staining showed stronger expression of vWF and TM in cirrhosis. Conclusion: The lack of difference in thrombogenicity of the portal vein between healthy liver and cirrhosis indicates no evidence of endothelial involvement in the development of portal vein thrombosis. Immunohistochemical assessment shows stronger staining of anti-vWF antibody and anti-TM antibody in blood vessels of cirrhosis compared to healthy liver. Future studies might further investigate whether this stronger anti-VWF and anti-TM staining in portal vein, vena cava inferior and hepatic artery of cirrhosis might be correlated to the development of thrombotic events in each vessel under specific circumstances.

Item Type:	Thesis (Thesis)
Supervisor name:	Lisman, Prof. Ton and Porte, Prof. Robert J.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:55
Last Modified:	25 Jun 2020 10:55
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1590

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