Title: Effect of Factor VIII and FVIII/PC Ratio on Portal Vein Thrombosis in Liver Cirrhosis:
A Systematic Review and Meta#analysis
Version: 4 Date: 30 Jul 2024
Reviewer:  Dmitry Victorovich Garbuzenko
Reviewer's report:
Portal vein thrombosis represents a well-known complication during the natural course of
liver cirrhosis, ranging from asymptomatic cases to life-threating conditions related to portal
hypertension and hepatic decompensation. According to the results of current studies, a
decreased portal blood #ow velocity below 15 cm/sec is a major risk factor for the development
of portal vein thrombosis. The role of hemostatic alterations (inherited or acquired), in particular,
the effect of factor VIII and FVIII/protein C ratio in the development of portal vein thrombosis in
cirrhotic patients is controversial and widely discussed. The authors presented a well#structured
systematic review and meta#analysis with qualitative statistical processing of the material, based
on the current understanding of this actual problem. I agree with the authors that this study is the
first to conduct a systematic review and meta-analysis to assess the effect of factor VIII activity
level and factor VIII/protein C ratio on the formation of portal vein thrombosis in cirrhotic
patients. Overall, his results were not a surprise. The activity levels of factor VIII were the same
in patients with cirrhosis of the liver with and without portal vein thrombosis, and the value of the
factor VIII/protein C ratio remained unclear. Considering that prospective/retrospective cohort
studies and case-control studies were included to research this problem, randomized controlled
trials involving a large number of patients are needed to assess the effect of factor VIII activity
level and factor VIII/protein C ratio on the formation of portal vein thrombosis in cirrhotic
patients.
Title: Effect of Factor VIII and FVIII/PC Ratio on Portal Vein Thrombosis in Liver Cirrhosis:
A Systematic Review and Meta#analysis
Version: 4 Date: 30 Jul 2024
Reviewer:  Dmitry Victorovich Garbuzenko
Reviewer's report:
Portal vein thrombosis represents a well-known complication during the natural course of
liver cirrhosis, ranging from asymptomatic cases to life-threating conditions related to portal
hypertension and hepatic decompensation. According to the results of current studies, a
decreased portal blood #ow velocity below 15 cm/sec is a major risk factor for the development
of portal vein thrombosis. The role of hemostatic alterations (inherited or acquired), in particular,
the effect of factor VIII and FVIII/protein C ratio in the development of portal vein thrombosis in
cirrhotic patients is controversial and widely discussed. The authors presented a well#structured
systematic review and meta#analysis with qualitative statistical processing of the material, based
on the current understanding of this actual problem. I agree with the authors that this study is the
first to conduct a systematic review and meta-analysis to assess the effect of factor VIII activity
level and factor VIII/protein C ratio on the formation of portal vein thrombosis in cirrhotic
patients. Overall, his results were not a surprise. The activity levels of factor VIII were the same
in patients with cirrhosis of the liver with and without portal vein thrombosis, and the value of the
factor VIII/protein C ratio remained unclear. Considering that prospective/retrospective cohort
studies and case-control studies were included to research this problem, randomized controlled
trials involving a large number of patients are needed to assess the effect of factor VIII activity
level and factor VIII/protein C ratio on the formation of portal vein thrombosis in cirrhotic
patients.
Please review this paper.
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Title: Effect of Factor VIII and FVIII/PC Ratio on Portal Vein Thrombosis in Liver Cirrhosis:
A Systematic Review and Meta#analysis
Version: 4 Date: 30 Jul 2024
Reviewer:  Dmitry Victorovich Garbuzenko
Reviewer's report:
Portal vein thrombosis represents a well-known complication during the natural course of
liver cirrhosis, ranging from asymptomatic cases to life-threating conditions related to portal
hypertension and hepatic decompensation. According to the results of current studies, a
decreased portal blood #ow velocity below 15 cm/sec is a major risk factor for the development
of portal vein thrombosis. The role of hemostatic alterations (inherited or acquired), in particular,
the effect of factor VIII and FVIII/protein C ratio in the development of portal vein thrombosis in
cirrhotic patients is controversial and widely discussed. The authors presented a well#structured
systematic review and meta#analysis with qualitative statistical processing of the material, based
on the current understanding of this actual problem. I agree with the authors that this study is the
first to conduct a systematic review and meta-analysis to assess the effect of factor VIII activity
level and factor VIII/protein C ratio on the formation of portal vein thrombosis in cirrhotic
patients. Overall, his results were not a surprise. The activity levels of factor VIII were the same
in patients with cirrhosis of the liver with and without portal vein thrombosis, and the value of the
factor VIII/protein C ratio remained unclear. Considering that prospective/retrospective cohort
studies and case-control studies were included to research this problem, randomized controlled
trials involving a large number of patients are needed to assess the effect of factor VIII activity
level and factor VIII/protein C ratio on the formation of portal vein thrombosis in cirrhotic
patients.
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