Treatment of direct oral anticoagulants in patients with liver cirrhosis and portal vein thrombosis

Ho Soo Chun, A. Reum Choe, Minjong Lee, Yuri Cho, Hwi Young Kim, Kwon Yoo, Tae Hun Kim

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Although patients with cirrhosis are known to be in a state of “rebalance” in that pro-and anticoagulant factors increase the risk for both bleeding and thrombosis, the prevalence of portal vein thrombosis (PVT) in patients with cirrhosis can be up to 26%. Therefore, physicians should consider anticoagulation for the prevention and management of PVT in patients with cirrhosis who are at high risk of PVT. Vitamin K antagonist or low molecular weight heparin is suggested as the standard treatment for PVT in cirrhosis. With the advent of new direct-acting oral anticoagulants (DOACs), there is a paradigm shift of switching to DOACs for the treatment of PVT in patients with cirrhosis. However, the safety and efficacy of DOACs in the treatment of PVT was not well-known in patients with cirrhosis. Therefore, this review focused on the current knowledge about the efficacy, safety concerns, and hepatic metabolism of DOACs in patients with cirrhosis and PVT. (Clin Mol Hepatol 2021;27:535-552).

Original languageEnglish
Pages (from-to)535-552
Number of pages18
JournalClinical and molecular hepatology
Volume27
Issue number4
DOIs
StatePublished - Oct 2021

Keywords

  • Anticoagulants
  • Liver cirrhosis
  • Portal vein
  • Thrombosis

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