Umbilical vein recanalization with a diameter greater than 6.48mm may promote deterioration of liver reserve function

Vollständiger Abstract

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This study aimed to investigate the clinical characteristics of cirrhotic patients with umbilical vein recanalization (UVR) and explore the effects of UVR on portal hypertension and liver reserve function (LRF). A total of 122 cirrhotic patients were enrolled and stratified into UVR and non-UVR groups based on the presence or absence of UVR. Clinical and laboratory indices, including hepatic biochemical parameters, portal venous system diameters, portal vein thrombosis, portal pressure gradient (PPG), Child-Pugh classification, and Model for End-Stage Liver Disease (MELD) scores, were compared between the 2 groups. Compared with the non-UVR group, patients in the UVR group had significantly lower serum albumin levels ( P = .032) and higher levels of aspartate aminotransferase ( P = .040) and total bilirubin ( P = .014). The UVR group also presented a markedly lower proportion of moderate-to-severe ascites ( P = .032), whereas no significant intergroup difference in PPG was detected. Additionally, the UVR group exhibited a significantly higher proportion of Child-Pugh B and C grades ( P = .031). Further subgroup analysis demonstrated that patients with a large UVR shunt (umbilical vein diameter > 6.48 mm) had worse Child-Pugh grade ( P = .044) and higher MELD scores ( P = .010) relative to non-UVR patients. In conclusion, UVR may alleviate moderate-to-severe ascites by reducing superior mesenteric venous pressure. An umbilical vein diameter exceeding 6.48 mm may be a potential risk factor for deteriorated liver reserve function. Although UVR does not significantly decrease portal venous pressure, it may aggravate portal hemodynamic burden and facilitate the progression of liver cirrhosis.