Thrombosis and anticoagulation in patients with Cirrhosis. An overview

Patients with cirrhosis are not spontaneously anticoagulated. Patients with cirrhosis are at risk of developing venous thromboembolism and atrial fibrillation. Anticoagulation does not independently increase the risk of bleeding related to portal hypertension; or the mortality and morbidity related to bleeding. VTE prophylaxis should be considered in hospitalized patients with cirrhosis. Deep vein thrombosis and pulmonary embolism should be treated with anticoagulation. Portal vein thrombosis is a marker for the severity of liver disease but likely not an aggravating factor. Current data suggest that anticoagulation therapy is beneficial in patients with cirrhosis and portal hypertension with or without portal vein thrombosis. Direct oral anticoagulants have taken a predominant place among anticoagulants in patients with cirrhosis in the absence of decompensation.