From thrombosis to transplantation: The role of anti-phospholipid antibodies in liver disease management

Antiphospholipid antibodies (aPLs) have been linked to a spectrum of liver diseases, though their precise clinical significance is still debated. This review comprehensively examines the prevalence and implications of aPLs in chronic liver conditions, such as viral and autoimmune liver diseases, with a focus on vascular disorders and complications related to liver transplantation. Emphasis is placed on the association of aPLs with thrombotic events and graft dysfunction. Our synthesis draws on various studies that highlight the presence of aPLs in patients with viral hepatitis, autoimmune liver conditions, and other chronic liver diseases, although definitive associations with vascular complications or adverse outcomes remain to be solidified. Some evidence suggests a possible link between aPLs and hepatic artery thrombosis post-transplant. Disparities in study findings may arise from methodological inconsistencies, such as population heterogeneity and assay variability. Vigilant assessment of thrombotic risk is crucial for patients with advanced liver disease or existing thrombophilic conditions. To better understand the role of aPLs in liver disease and transplantation outcomes, robust longitudinal research with standardized methodologies is imperative.