Review for 10.1186/s12876-024-03322-8 (2024)

Title: Analysis of factors related to recanalization of portal vein thrombosis in liver cirrhosis:
a retrospective cohort study
Version: 1 Date: 21 Jan 2024
Reviewer's report:
The authors focused on predicting factors influencing portal vein thrombosis (PVT)
recanalization and the benefits of anticoagulant therapy in patients with cirrhosis. A retrospective
evaluation was conducted on 258 patients who developed PVT in the context of liver cirrhosis
between 2016 and 2022. The primary outcomes included PVT recanalization or progression,
with patient follow-up until death, liver transplantation, or May 2023. The results suggest that
anticoagulant therapy may enhance PVT recanalization rates, improve liver function, and not
increase bleeding risks.
This paper provides valuable insights into the management of PVT in patients with cirrhosis.
It is well-structured and clearly explains the research design and statistical analyses. However,
there are key points that could be strengthened.
Major Comments:
Imaging Assessment Criteria Clarification:
The study appropriately utilizes imaging to assess PVT recanalization or progression. However,
the criteria used for determining "complete recanalization" and "partial recanalization" need
explicit clarification. Detail the specific characteristics considered during the assessment to
ensure transparency and facilitate the reproducibility of your findings.
Statistical Analysis Rationale:
While the statistical methods are described, provide a more in-depth explanation of the rationale
behind selecting the Cox regression model. Discuss potential confounders and how they were
addressed in the analysis. Additionally, consider presenting the assumptions and limitations of
the statistical model chosen for a more nuanced interpretation of the results.
Long-Term Follow-Up and Liver Function Changes:
The study mentions follow-up until May 2023, but the duration of follow-up for individual
patients is not specified. To accurately evaluate the long-term impact of anticoagulation, report
the duration of follow-up for each patient. Moreover, the observed improvements in liver
function with anticoagulation require further elucidation. Specify the markers used for assessing
liver function and discuss the clinical relevance of these changes.
Minor Comments:
Inclusion and Exclusion Criteria Elaboration:
Provide additional insights into how patients meeting the inclusion criteria were identified
during the retrospective evaluation. Discuss any considerations or challenges encountered in the
patient selection process and address how potential selection biases were mitigated.
Anticoagulation Regimen Rationale:
The study mentions various anticoagulation regimens without discussing the rationale behind
selecting specific anticoagulants and their dosages. Briefly discuss whether the choice of
anticoagulant was influenced by individual patient characteristics or preferences, providing
context for the reported treatments.
Discussion Section Enrichment:
While the discussion provides valuable insights, consider expanding on the implications of your
findings and their alignment with existing literature. Delve deeper into the potential limitations
of the study, and propose avenues for future research based on the observed outcomes. A more
thorough exploration will enhance the overall discussion section.
These comments aim to improve the transparency and depth of the paper, providing readers with
a clearer understanding of the research.