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Current Hepatology Reports

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01-06-2020 | Portal Vein Thrombosis | Management of the Cirrhotic Patient (A Cardenas and P Tandon, Section Editors)

Therapeutic and Prophylactic Anticoagulation in Cirrhosis Patients

Authors: Lauren Carlini, Stephen Caldwell

Published in: Current Hepatology Reports | Issue 2/2020

Abstract

Purpose of Review

Because of the complexity of changes in the pro- and anti-hemostatic cascades in liver disease, therapeutic and prophylactic anticoagulation in cirrhosis patients is currently one of the most challenging areas in clinical medicine. We have endeavored to comprehensively address the most salient issues and controversies in this field based on the current literature.

Recent Findings

Laboratory and clinical science discoveries which have accrued over the past several decades have dramatically changed our understanding of hemostatic pathways in patients with chronic liver disease. As a result, many past clinical tenets are no longer supported by existing laboratory and current clinical science.

Summary

We present current data in cirrhosis patients regarding the treatment of portal vein and peripheral deep vein thrombosis and prophylactic strategies for peripheral thrombotic disease as well as for cirrhosis patients with co-existent atrial fibrillation. We also present very provocative data on prophylaxis of portal vein thrombosis in patients with underlying liver disease. The latter, if confirmed with blinded prospective study, could have an impact on chronic liver failure and the need for liver transplantation.

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Title: Therapeutic and Prophylactic Anticoagulation in Cirrhosis Patients
Authors: Lauren Carlini
Stephen Caldwell
Publication date: 01-06-2020
Publisher: Springer US
Keywords: Portal Vein Thrombosis
Direct Oral Anticoagulant
Atrial Fibrillation
Portal Vein Thrombosis
Warfarin
Thrombosis
Direct Oral Anticoagulant
Low Molecular Weight Heparin
Published in: Current Hepatology Reports / Issue 2/2020
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-020-00516-y

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