Safety and Efficacy of Anticoagulation Therapy With Low Molecular Weight Heparin for Portal Vein Thrombosis in Patients With Liver Cirrhosis

Amitrano, Lucio; Guardascione, Maria Anna; Menchise, A.; Martino, R.; Scaglione, Mariano; Giovine, S; Romano, Luigia; Balzano, A.

doi:10.1097/mcg.0b013e3181b3ab44

Cited by 276 publications

(162 citation statements)

References 18 publications

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“…An attractive alternative to oral anticoagulants could be the use of low-molecular-weight heparin (LMWH), the dosing of which is weight based and thus does not necessitate screening. A 50%-80% portal vein recanalization rate was recently reported with the use of LMWH in 38 patients with cirrhosis, with only a few episodes of non-severe variceal bleeding [62,80] . Villa et al [81] performed a randomized controlled trial to evaluate the safety and efficacy of enoxaparin, a LMWH, in preventing PVT in patients with advanced cirrhosis.…”

Section: Treatmentmentioning

confidence: 99%

“…It has also been shown that individuals with PVT at the time of liver transplantation are at higher risk of recurrent PVT after transplantation and of requiring retransplantation [30,70] . The increased mortality and morbidity rates associated with PVT are mostly restricted to the first year after liver transplantation [4,62] and actuarial survival after 1 year is good. Therefore, PVT cannot be considered to be a contraindication to liver transplantation [71] .…”

Section: Treatmentmentioning

confidence: 99%

“…PVT increases the risk of variceal bleeding and is reportedly an independent risk factor for the inability to control variceal bleeding [62] . In addition, PVT can be a life-threatening emergency when it extends to the superior mesenteric vein, leading to intestinal infarction.…”

Section: Treatmentmentioning

confidence: 99%

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Portal vein thrombosis in liver cirrhosis

Kinjo¹,

Kawanaka²,

Akahoshi³

et al. 2014

WJH

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Portal vein thrombosis (PVT) is considered to be a frequent complication of liver cirrhosis. However, unlike PVT in patients without cirrhosis, very few data are available on the natural history and management of PVT in cirrhosis, despite its association with potentially life-threatening conditions, such as gastroesophageal bleeding and acute intestinal ischemia. Moreover, no consensus regarding PVT in cirrhosis exists. Suggested causes of PVT in cirrhosis include reduced portal blood flow velocity, multiple congenital or acquired thrombophilic factors, inherited or acquired conditions, and derangement of liver architecture. However, the understanding of PVT in cirrhosis is incomplete. In addition, information on the management of PVT in cirrhosis is inadequate. The aims of this review are to: (1) assemble data on the physiopathological mechanism, clinical findings, diagnosis and management of PVT in cirrhosis; (2) describe the principal factors most frequently involved in PVT development; and (3) summarize the recent knowledge concerning diagnostic and therapeutic procedures.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Portal vein thrombosis; Liver cirrhosis; Thrombophilic factors; Anticoagulation; Splenectomy Core tip: Portal vein thrombosis (PVT) is considered to be a frequent complication of liver cirrhosis; however, very few data are available on the natural history and management of PVT in cirrhosis, despite its association with potentially life-threatening conditions. The understanding and information on the management of PVT in cirrhosis are incomplete. The aims of this review are to: (1) assemble data on the physiopathological mechanism, clinical findings, diagnosis and management of PVT in cirrhosis; (2) describe the principal factors most frequently involved in PVT development; and (3) summarize the recent knowledge concerning diagnostic and therapeutic procedures.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Portal vein thrombosis in liver cirrhosis

Kinjo¹,

Kawanaka²,

Akahoshi³

et al. 2014

WJH

View full text Add to dashboard Cite

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“…Similar findings were also made in patients not on a waiting list for liver transplantation. Enoxaparin was given at therapeutic doses for 6 months to 28 patients with PVT, after endoscopic variceal eradication [90]. Recanalization was complete, partial and absent in 33.3 %, 50 %, and 16.7 % of patients, respectively.…”

Section: Anticoagulation For the Treatment Of Pvtmentioning

confidence: 99%

Splanchnic and Extrasplanchnic Thrombosis in Cirrhosis: Prophylaxis vs Treatment

Nery

Valla

2014

Curr Hepatology Rep

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Venous thromboembolism (deep vein thrombosis and pulmonary embolism) and portal vein thrombosis (PVT) occur in up to 6.3 % and 15.9 % of patients with cirrhosis, respectively. There is recent evidence that a procoagulable prothrombotic state is related to cirrhosis despite the reduced levels of many coagulation factors, and decreased platelet counts. Indeed, (i) the combination of high levels of factor VIII, with low levels of protein C and antithrombin induces a procoagulant state in vitro; while (ii) increased levels of von Willebrand factor and decreased ADAMTS 13 activity can compensate for decreased platelet counts.

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“…Yet, at least in the absence of bleeding, there is no data to support withholding anticoagulation from patients with cirrhosis. In general, anticoagulation is safe and well tolerated in cirrhosis [28,29]. Moreover, severity of disease, but not anticoagulation was associated with poor outcome in cirrhosis patients with upper gastrointestinal bleeding [30].…”

Section: Therapeutic Aspects and Recommendations For Cirrhosis Patienmentioning

confidence: 99%

Management of Coagulopathy during Bleeding and Invasive Procedures in Patients with Liver Failure

2018

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Alterations in hemostasis are a characteristic feature of advanced liver disease. Patients with coagulopathy of advanced liver disease are prone to bleedings and also thromboembolic events. Under stable conditions, cirrhosis patients show alterations in both pro- and anticoagulatory pathways, frequently resulting in a rebalanced hemostasis. This review summarizes current recommendations of management during bleeding and prior to invasive procedures in patients with cirrhosis.

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Safety and Efficacy of Anticoagulation Therapy With Low Molecular Weight Heparin for Portal Vein Thrombosis in Patients With Liver Cirrhosis

Abstract: LMWH demonstrated safe and effective in the treatment of PVT in patients with liver cirrhosis.

Cited by 276 publications

References 18 publications

Portal vein thrombosis in liver cirrhosis

Portal vein thrombosis in liver cirrhosis

Splanchnic and Extrasplanchnic Thrombosis in Cirrhosis: Prophylaxis vs Treatment

Management of Coagulopathy during Bleeding and Invasive Procedures in Patients with Liver Failure

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