Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 8, 2015; 7(13): 1730-1734
Published online Jul 8, 2015. doi: 10.4254/wjh.v7.i13.1730
Changing common sense: Anti-platelet/coagulation therapy against cirrhosis
Yoshihiro Ikura, Tatsuya Osuga
Yoshihiro Ikura, Department of Pathology, Takatsuki General Hospital, Takatsuki 569-1192, Japan
Tatsuya Osuga, Department of Gastroenterology, Takatsuki General Hospital, Takatsuki 569-1192, Japan
Author contributions: Ikura Y designed the concept and wrote the manuscript; Osuga T designed the concept, prepared the figures and checked the manuscript.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yoshihiro Ikura, MD, Department of Pathology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan. ikura@ajk.takatsuki-hp.or.jp
Telephone: +81-72-6813801 Fax: +81-72-6823834
Received: January 25, 2015
Peer-review started: January 27, 2015
First decision: March 20, 2015
Revised: March 29, 2015
Accepted: April 28, 2015
Article in press: April 30, 2015
Published online: July 8, 2015

Until recently, anti-platelet/coagulation therapy had not been recommended for patients with cirrhosis. Although venous thrombosis is one of the representative complications of cirrhosis and ischemic disorders associated with atherosclerosis are not infrequent in cirrhotic patients, many clinicians have tended to hesitate to introduce anti-platelet/coagulation therapy to their patients. Undoubtedly, this is due to the increased risk of hemorrhagic diathesis in cirrhotic patients. However, accumulating evidence has revealed the benefits of anti-platelet/coagulation therapy for cirrhotic patients. In addition to the safety of the therapy carried out against cardiovascular diseases in cirrhotic patients, some clinical data have indicated its preventive effect on venous thrombosis. Moreover, the efficacy of anti-platelet/coagulation therapy against cirrhosis itself has been demonstrated both clinically and experimentally. The conceptual basis for application of anti-platelet/coagulation therapy against cirrhosis was constructed through two pathologic studies on intrahepatic thrombosis in cirrhotic livers. It may be better to use thrombopoietin-receptor agonists, which have been tested as a treatment for cirrhosis-related thrombocytopenia, in combination with anti-platelet drugs to reduce the risk of venous thrombosis. During the last decade, the World Journal of Gastroenterology, a sister journal of World Journal of Hepatology, has been one of the main platforms of active discussion of this theme.

Keywords: Anti-platelet/coagulation therapy, Cirrhosis, Hemorrhagic diathesis, Thrombosis, Thrombocytopenia

Core tip: Recognition concerning anti-platelet/coagulation therapy for cirrhotic patients has been changing from relative contraindication to recommendable. Administration of this type of drugs is expected to not only prevent cirrhosis-related thrombotic disorders but also slow down the progression of liver disease itself.