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KMID : 1040620210270040535
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Clinical and Molecular Hepatology
2021 Volume.27 No. 4 p.535 ~ p.552
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Treatment of direct oral anticoagulants in patients with liver cirrhosis and portal vein thrombosis
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Chun Ho-Soo
Choe A-Reum
Lee Min-Jong
Cho Yu-Ri
Kim Hwi-Young
Yoo Kwon
Kim Tae-Hun
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Abstract
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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.
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KEYWORD
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Anticoagulants, Portal vein, Thrombosis, Liver cirrhosis
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