Advancements of direct oral anticoagulants in cirrhotic individuals with portal vein thrombosis

Abstract

Individuals with cirrhosis maintain a delicate balance between pro- and anticoagulation, which can lead to a state of hypercoagulability. This hypercoagulable condition not only exacerbates liver fibrosis but also increases the risk of venous thrombosis, particularly portal vein thrombosis (PVT). PVT has detrimental effects on liver function, complicates the success of liver transplantation, and negatively impacts the survival rate of patients with cirrhosis. Currently, multiple studies have confirmed that individuals with cirrhosis responded well to treatment with novel direct oral anticoagulants (DOACs), showing both safety and efficacy. Furthermore, the use of DOACs as a preventive measure in patients with cirrhosis following surgery has been shown to lower the occurrence of portal vein thrombosis and postpone the progression of liver fibrosis.