Department of Gastroenterology, University of Modena & Reggio Emilia and Azienda Ospedaliero-Universitaria di Modena, Italy; PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
Emmanuelle de Raucourt
Service d'hématologie biologique, CHU Paris Nord-Val de Seine - Hôpital Beaujon, Clichy, France
Dominique-Charles Valla
Service d'hépatologie, CHU Paris Nord-Val de Seine - Hôpital Beaujon, Clichy, France; Corresponding authors. Addresses: CHU Paris Nord-Val de Seine - Hôpital Beaujon, 100 boulevard du Général Leclerc, 92110 Clichy, France (D.-C. Valla), or Department of Gastroenterology, University of Modena & Reggio Emilia and Azienda Ospedaliero-Universitaria di Modena, Via del Pozzo 71, Modena, 41124, Italy (E. Villa).
Erica Villa
Department of Gastroenterology, University of Modena & Reggio Emilia and Azienda Ospedaliero-Universitaria di Modena, Italy; Corresponding authors. Addresses: CHU Paris Nord-Val de Seine - Hôpital Beaujon, 100 boulevard du Général Leclerc, 92110 Clichy, France (D.-C. Valla), or Department of Gastroenterology, University of Modena & Reggio Emilia and Azienda Ospedaliero-Universitaria di Modena, Via del Pozzo 71, Modena, 41124, Italy (E. Villa).
Summary: In the past, patients with liver cirrhosis were thought to be prone to increased bleeding risk. However, those with compensated liver cirrhosis actually have normal coagulative balance, which can become altered when liver function worsens, or infection, bleeding, or acute kidney insufficiency occur. When this happens, it is now recognized that patients with liver cirrhosis are at higher risk of thrombotic rather than haemorrhagic complications. Anticoagulation plays a favourable role both when used therapeutically or prophylactically. Successful anticoagulation is associated with a lower rate of decompensation and with improved survival. To date, treatment has involved the use of low molecular weight heparins and vitamin K antagonists. Preliminary data suggest that novel non-vitamin K antagonist oral anticoagulants can be used safely in patients with liver cirrhosis. Keywords: Coagulopathy, Thrombophilia, Chronic liver disease, Portal Hypertension, Decompensation
