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In most cases, portal vein thrombosis progresses without treatment; spontaneous recanalization of portal vein develops in 42 % of patients with liver cirrhosis. Effective treatment strategies include administration of anticoagulants, interventional procedures such as transjugular intrahepatic porto-systemic shunt or endovascular fibrinolysis. Anticoagulant therapy has certain difficulties in patients with liver cirrhosis due to the complex profile of hemostasis, a tendency to both hemorrhages and hypercoagulation. In addition to traditional anticoagulants (heparin preparations, fondaparinux, vitamin K antagonists), direct oral anticoagulants have been widely used in recent years for portal vein thrombosis. Previously, portal vein thrombosis was considered a contraindication to performing transjugular intrahepatic porto-systemic shunt, currently the method is often used to restore portal blood flow through the shunt and prevent repeated thrombosis. Endovascular fibrinolysis is still an option for specialized centers for «difficult» patients. In cases of increased risk of venous thromboembolism, patients with liver cirrhosis are recommended to be prevented with low-molecular-weight heparin or direct oral anticoagulants, but further studies should clarify their effectiveness in this aspect. The review highlights data on the features of therapy, primary and secondary prevention of portal vein thrombosis in patients with liver cirrhosis. Despite the existing clinical recommendations for management of patients with cirrhotic portal vein thrombosis, the choice of a particular strategy primarily depends on an individualized assessment of risks and benefits of each treatment method.

Portal vein thrombosis is the most common thrombotic complication in patients with liver cirrhosis, especially in cases of severe forms. The pathogenesis is multifactorial in nature, it determined by a change in the balance between the coagulation and anticoagulation systems. Thrombosis is often asymptomatic and is accidentally detected, although it can be complicated by varicose bleeding, intestinal ischemia, and portal biliopathy. Ultrasound Doppler examination is a screening method, as an alternative, computed tomography and magnetic resonance imaging are used. The review highlights data on epidemiology, risk factors, clinical features, and diagnosis of portal vein thrombosis in patients with liver cirrhosis. The data on the effect of portal vein thrombosis on the progression of liver cirrhosis and the survival of patients, including after liver transplantation, are presented.

Aim of investigation. To establish interrelation of intercellular interaction mediators with histological changes at chronic viral liver disease.Material and methods. Blood contents of immunoglobulins superfamily and selectin molecules was investigated in 101 patients with chronic viral liver diseases. Scores of ICAM-1, VCAM-1, Е-selectin, L-selectin and the Р-selectin were determined by enzyme-linked immunoassay method and were compared to values of Knodell histological activity index and Desmet fibrosis score as well as to E.M. Brunt hepatic steatosis levels.Results. At chronic viral hepatitis ICAM-1 and selectins blood contents increase whereas in patients with liver cirrhosis elevation of all adhesin levels was marked. Concentration of ICAM-1, VCAM-1, Е-, L-and Р-selectin at chronic viral liver diseases was increased along with increase of severity of inflammation and severity of hepatic fibrosis and had positive correlation with histological activity indexes (HAI) and liver fibrosis. Positive correlation of ICAM-1, VCAM-1 and Е-selectin with degree of liver steatosis was found. Level of immunoglobulin superfamily and selectin molecules were characterized by sufficient accuracy in detection of HAI over 8 points and detection of moderate/severe degree of fibrosis.Conclusions. Association of morphological signs with mediators of intercellular interactions indicates their important role in development and progression of chronic viral liver disease.