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Recommendations for management of portal vein thrombosis in cirrhosis

Portal vein thrombosis (PVT) in patients with cirrhosis is probably the most commonly encountered form of thrombosis affecting the splanchnic vessels. Actually, this variant is sufficiently common for a wide awareness, and for the bulk of data on it to be exponentially increasing; but sufficiently uncommon for good quality data to be scarce in pressing areas for clinical management; hence the importance of periodic systematic reviews and meta-analyses, and the need for translation of their findings into recommendations by experienced clinicians. This issue of the Journal of Digestive Diseases contains a remarkable consensual expert review on the management of PVT in liver cirrhosis, prompted by the Hepatobiliary Disease Study Group of the Chinese Society of Gastroenterology of the Chinese Medical Association. The background of PVT in cirrhosis differs by many aspects in Chinese and western patients. Therefore the following comments will focus on the variations between the current Chinese recommendations and the recently reported 2020 Practice Guidance by the American Association for the Study of Liver Diseases, elaborated independently. As similar statements compose recommendations and similar areas of uncertainties are also pointed out, the variations under scrutiny amount more to nuances than to true differences.