Title: Association of Thromboelastography Profile with Severity of Liver Cirrhosis and Portal
Venous System Thrombosis
Version: 1 Date: 07 Mar 2021
Reviewer's report:
REVIEW
This is a well written paper regarding  the association of thromboelastography profile with the
severity of liver cirrhosis and portal venous system thrombosis(PVST).The authors evaluated
two cohorts with overall 166 cirrhotic patients.They compared thromboelastography(TEG)
parameters between cirrhotic patients with Child-Pugh class A and B/C, those with and without
decompensation, and those with and without PVST. They concluded that hypercoagulability
might not be related to more advanced stages of liver cirrhosis or presence of PVST  using a novel
definition of hypercoaguability and that there is a high rate of discordance between  reactive
time  and other thromboelastography parameters.
However ,there are some issues which should be addressed by the authors
1) Using different TEG facilities and reference ranges despite applying the same reagents makes
the evaluation of results between the two cohorts  precarious
2) It would be interesting to separately analyze the data for Child Pugh B and Child Pugh C
patients.Is there any particular reason for merging these two groups?
3) The study excludes cirrhotics with common complications of the disease that are more likely
to have a more severe disease
4) The exlusion criteria  preclude the most common risk factors for PSVT in cirrhotic patients
so the study population may not be  representative
5)  Also,what was the time limit for an abdominal surgery that made someone ineligible for
the study?
6) Authors should provide more information about the definition of hypercoagulability
Title: Association of Thromboelastography Profile with Severity of Liver Cirrhosis and Portal
Venous System Thrombosis
Version: 1 Date: 07 Mar 2021
Reviewer's report:
REVIEW
This is a well written paper regarding  the association of thromboelastography profile with the
severity of liver cirrhosis and portal venous system thrombosis(PVST).The authors evaluated
two cohorts with overall 166 cirrhotic patients.They compared thromboelastography(TEG)
parameters between cirrhotic patients with Child-Pugh class A and B/C, those with and without
decompensation, and those with and without PVST. They concluded that hypercoagulability
might not be related to more advanced stages of liver cirrhosis or presence of PVST  using a novel
definition of hypercoaguability and that there is a high rate of discordance between  reactive
time  and other thromboelastography parameters.
However ,there are some issues which should be addressed by the authors
1) Using different TEG facilities and reference ranges despite applying the same reagents makes
the evaluation of results between the two cohorts  precarious
2) It would be interesting to separately analyze the data for Child Pugh B and Child Pugh C
patients.Is there any particular reason for merging these two groups?
3) The study excludes cirrhotics with common complications of the disease that are more likely
to have a more severe disease
4) The exlusion criteria  preclude the most common risk factors for PSVT in cirrhotic patients
so the study population may not be  representative
5)  Also,what was the time limit for an abdominal surgery that made someone ineligible for
the study?
6) Authors should provide more information about the definition of hypercoagulability
Please review this paper.
user
Title: Association of Thromboelastography Profile with Severity of Liver Cirrhosis and Portal
Venous System Thrombosis
Version: 1 Date: 07 Mar 2021
Reviewer's report:
REVIEW
This is a well written paper regarding  the association of thromboelastography profile with the
severity of liver cirrhosis and portal venous system thrombosis(PVST).The authors evaluated
two cohorts with overall 166 cirrhotic patients.They compared thromboelastography(TEG)
parameters between cirrhotic patients with Child-Pugh class A and B/C, those with and without
decompensation, and those with and without PVST. They concluded that hypercoagulability
might not be related to more advanced stages of liver cirrhosis or presence of PVST  using a novel
definition of hypercoaguability and that there is a high rate of discordance between  reactive
time  and other thromboelastography parameters.
However ,there are some issues which should be addressed by the authors
1) Using different TEG facilities and reference ranges despite applying the same reagents makes
the evaluation of results between the two cohorts  precarious
2) It would be interesting to separately analyze the data for Child Pugh B and Child Pugh C
patients.Is there any particular reason for merging these two groups?
3) The study excludes cirrhotics with common complications of the disease that are more likely
to have a more severe disease
4) The exlusion criteria  preclude the most common risk factors for PSVT in cirrhotic patients
so the study population may not be  representative
5)  Also,what was the time limit for an abdominal surgery that made someone ineligible for
the study?
6) Authors should provide more information about the definition of hypercoagulability
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