PB0860 - Von Willebrand factor is an independent predictor of short-term mortality in acutely ill patients with cirrhosis

Monday, June 26, 2023

18:30 – 19:30 ET

Room: Exhibition

Presenting Author(s)

Bente P. van den Boom, MD

PhD-candidate
University Medical Center Groningen
Utrecht, Utrecht, Netherlands

Co-Author(s)

MS

Marilena Stamouli

Researcher
Institute of Hepatology, Foundation for Liver Research London
London, England, United Kingdom
WB

William Bernal

Professor of Liver Critical Care
Institute of Liver Studies & Transplantation, King's College Hospital London
London, England, United Kingdom
AB

Annabel Blasi

Anesthesiologist
Hospital Clinic Barcelona
Barcelona, Catalonia, Spain
JA

Jelle Adelmeijer

Analyst
UMCG
Groningen, Groningen, Netherlands
JF

Javier Fernandez

Hepatology consultant
Hospital Clinic Barcelona
Barcelona, Catalonia, Spain
Ton Lisman, PhD

Professor of Experimental Surgery
UMCG
Groningen, Groningen, Netherlands
VP

Vishal C. Patel

Hepatology consultant
Institute of Hepatology, Foundation for Liver Research London
London, England, United Kingdom

Background: Levels of von Willebrand factor (VWF) are elevated in patients with cirrhosis, and correlate well with disease severity. In patients with acutely decompensated (AD) cirrhosis, plasma VWF is associated with mortality. The value of VWF in predicting short-term mortality risk in patients with acute-on-chronic liver failure (ACLF) is, however, unclear.

Aims: In this study, we aimed to investigate the predictive value of VWF in a larger cohort of patients with AD and ACLF.

Methods: We included patients with AD (n=111) and ACLF (n=105). We measured VWF levels and correlated these with other laboratory parameters and prediction models for mortality. Also, we assessed the predictive value of VWF in prediction of 90 and 30 day mortality in patients with AD and ACLF, respectively, and compared this to the predictive value of clinically used prediction models. Finally, we determined the optimal cut-off value for VWF in patients with ACLF.

Results: Sixteen of 111 (14%) patients with AD and 35 of 105 (33%) with ACLF died within 90 days and 30 days, respectively. VWF was associated with mortality and correlated closely with other prediction models. In patients with ACLF, VWF levels had a discrimination for 30 day mortality comparable with these models and accurately identified ACLF patients with high 30 day mortality risk.

Conclusion(s): Levels of VWF associate closely with risk of mortality in patients with AD and ACLF, and may have predictive utility as a laboratory marker of prognosis. However, it remains unclear when and how to use this marker in a clinical setting.