Treatment of direct oral anticoagulants in patients with liver cirrhosis and portal vein thrombosis
- Author:
Ho Soo CHUN
1
;
A Reum CHOE
;
Minjong LEE
;
Yuri CHO
;
Hwi Young KIM
;
Kwon YOO
;
Tae Hun KIM
Author Information
- Publication Type:Review
- From:Clinical and Molecular Hepatology 2021;27(4):535-552
- CountryRepublic of Korea
- Language:English
- 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.
