Journal
JHEP REPORTS
Volume 1, Issue 3, Pages 227-239Publisher
ELSEVIER
DOI: 10.1016/j.jhepr.2019.02.006
Keywords
Coagulopathy; Thrombophilia; Chronic liver disease; Portal Hypertension; Decompensation
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In the past, patients with liver cirrhosis were thought to be prone to increased bleeding risk. However, those with compensated liver cirrhosis actually have normal coagulative balance, which can become altered when liver function worsens, or infection, bleeding, or acute kidney insufficiency occur. When this happens, it is now recognized that patients with liver cirrhosis are at higher risk of thrombotic rather than haemorrhagic complications. Anticoagulation plays a favourable role both when used therapeutically or prophylactically. Successful anticoagulation is associated with a lower rate of decompensation and with improved survival. To date, treatment has involved the use of low molecular weight heparins and vitamin K antagonists. Preliminary data suggest that novel non-vitamin K antagonist oral anticoagulants can be used safely in patients with liver cirrhosis. (C) 2019 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL).
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