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Semin Thromb Hemost 2015; 41(05): 514-519
DOI: 10.1055/s-0035-1550436
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Anticoagulant Therapy in Patients with Cirrhosis

Nicolas M. Intagliata
1   Division of Gastroenterology and Hepatology, University of Virginia Health System, University of Virginia, Charlottesville, Virginia
,
Patrick G. Northup
1   Division of Gastroenterology and Hepatology, University of Virginia Health System, University of Virginia, Charlottesville, Virginia
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Publikationsdatum:
06. Juni 2015 (online)

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Abstract

Recent studies have greatly expanded our understanding of the coagulopathy of cirrhosis. It is clear that cirrhosis patients are at a risk of both bleeding and thrombosis. While prediction of these events remains challenging, cirrhosis patients are not protected from the development of venous and arterial thrombosis. In fact, studies show that hypercoagulability may promote hepatic decompensation and development of fibrosis. Anticoagulation for thrombosis is now becoming a common prospect in many clinical situations. Our understanding of the efficacy and safety of commonly used therapeutics is only beginning to emerge and the risks and benefits remain unclear in this unique population. In this review, we discuss the role of anticoagulation in the treatment and prevention peripheral and splanchnic thrombosis in patients with cirrhosis, as well as examine the potential role of anticoagulants in altering the progression of chronic liver disease.

Keywords

liver disease - deep venous thrombosis - thrombosis - warfarin - heparin
 

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