Reviewer ’s report  
 
Title: Portal vein thrombosis in liver cirrhosis: Incidence, management, and outcome  
 
Version: 0 Date: 17 May 2017  
 
Reviewer: Arif Cosar  
 
Reviewer's report:  
 
Thanks to authors for presenting interesting article to BMC gastroenterology. Several studies 
have implicated the usefulness of danap aroid sodium and/or antithrombin III, in the treatment of 
portal vein thrombosis in patients with liver cirrhosis. Although the subject of this study is 
interesting and important, the methodology has a few pitfalls. As authors described in the 
discussion s ection, this study used retrospective cohort format and I think selection bias cannot 
be excluded.  The introduction part of manuscript is a little long. All patient have relatively low 
Child -Pugh score, compared to the patients in real life.  
- What do you mean with "acute cirrhosis" and how did you diagnose it?  Acute type cirrhosis? 
(8-130) 
"We divided the patients into two groups; patients of the acute type (n=27) developed cirrhosis 
within one month after hepatectomy (16 cases) or splenectomy (11 cases),  while those of the 
chronic type (n=63) comprised all other patients".  
 
- You mean "the risk of progression of of PVT"?  (14 -245) 
"The results of this study showed that anticoagulation with DS is safe and effective treatment, 
significantly reducing the risk  of PVT and liver decompensation"  
 
- Which study's results? (14 -260) and, in which kind of patients?  
"Our results showed cumulative incidence of PVT of 4.6%, 8.2%, and 10.7% at 1, 3, and 5 years,  
respectively, suggesting high risk of PVT even at baseline and that such risk remains stable over 
time".  
 
- Did the patients have any other reason for PVT other than cirrhosis, such as 
hypercoagulapathy? In addition, was there any relationship between treatm ent responses?  
- What is the role of spontaneous portal vein recanalization in your study?  
- What is the final and new message of this study? It must be clearer in the conclusion part of 
manuscript.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include th e necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to asse ss any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you recei ved reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors ' 
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Portal vein thrombosis in liver cirrhosis: Incidence, management, and outcome  
 
Version: 0 Date: 17 May 2017  
 
Reviewer: Arif Cosar  
 
Reviewer's report:  
 
Thanks to authors for presenting interesting article to BMC gastroenterology. Several studies 
have implicated the usefulness of danap aroid sodium and/or antithrombin III, in the treatment of 
portal vein thrombosis in patients with liver cirrhosis. Although the subject of this study is 
interesting and important, the methodology has a few pitfalls. As authors described in the 
discussion s ection, this study used retrospective cohort format and I think selection bias cannot 
be excluded.  The introduction part of manuscript is a little long. All patient have relatively low 
Child -Pugh score, compared to the patients in real life.  
- What do you mean with "acute cirrhosis" and how did you diagnose it?  Acute type cirrhosis? 
(8-130) 
"We divided the patients into two groups; patients of the acute type (n=27) developed cirrhosis 
within one month after hepatectomy (16 cases) or splenectomy (11 cases),  while those of the 
chronic type (n=63) comprised all other patients".  
 
- You mean "the risk of progression of of PVT"?  (14 -245) 
"The results of this study showed that anticoagulation with DS is safe and effective treatment, 
significantly reducing the risk  of PVT and liver decompensation"  
 
- Which study's results? (14 -260) and, in which kind of patients?  
"Our results showed cumulative incidence of PVT of 4.6%, 8.2%, and 10.7% at 1, 3, and 5 years,  
respectively, suggesting high risk of PVT even at baseline and that such risk remains stable over 
time".  
 
- Did the patients have any other reason for PVT other than cirrhosis, such as 
hypercoagulapathy? In addition, was there any relationship between treatm ent responses?  
- What is the role of spontaneous portal vein recanalization in your study?  
- What is the final and new message of this study? It must be clearer in the conclusion part of 
manuscript.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include th e necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to asse ss any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you recei ved reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors ' 
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Portal vein thrombosis in liver cirrhosis: Incidence, management, and outcome  
 
Version: 0 Date: 17 May 2017  
 
Reviewer: Arif Cosar  
 
Reviewer's report:  
 
Thanks to authors for presenting interesting article to BMC gastroenterology. Several studies 
have implicated the usefulness of danap aroid sodium and/or antithrombin III, in the treatment of 
portal vein thrombosis in patients with liver cirrhosis. Although the subject of this study is 
interesting and important, the methodology has a few pitfalls. As authors described in the 
discussion s ection, this study used retrospective cohort format and I think selection bias cannot 
be excluded.  The introduction part of manuscript is a little long. All patient have relatively low 
Child -Pugh score, compared to the patients in real life.  
- What do you mean with "acute cirrhosis" and how did you diagnose it?  Acute type cirrhosis? 
(8-130) 
"We divided the patients into two groups; patients of the acute type (n=27) developed cirrhosis 
within one month after hepatectomy (16 cases) or splenectomy (11 cases),  while those of the 
chronic type (n=63) comprised all other patients".  
 
- You mean "the risk of progression of of PVT"?  (14 -245) 
"The results of this study showed that anticoagulation with DS is safe and effective treatment, 
significantly reducing the risk  of PVT and liver decompensation"  
 
- Which study's results? (14 -260) and, in which kind of patients?  
"Our results showed cumulative incidence of PVT of 4.6%, 8.2%, and 10.7% at 1, 3, and 5 years,  
respectively, suggesting high risk of PVT even at baseline and that such risk remains stable over 
time".  
 
- Did the patients have any other reason for PVT other than cirrhosis, such as 
hypercoagulapathy? In addition, was there any relationship between treatm ent responses?  
- What is the role of spontaneous portal vein recanalization in your study?  
- What is the final and new message of this study? It must be clearer in the conclusion part of 
manuscript.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include th e necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to asse ss any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares  in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you recei ved reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors ' 
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant