Biolato M, Paratore M, Di Gialleonardo L, Marrone G, Grieco A. Direct oral anticoagulant administration in cirrhotic patients with portal vein thrombosis: What is the evidence? World J Hepatol 2022; 14(4): 682-695 [PMID: 35646264 DOI: 10.4254/wjh.v14.i4.682]
Corresponding Author of This Article
Marco Biolato, MD, PhD, Staff Physician, Internal and Liver Transplant Medicine Unit, CEMAD, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, Rome 00168, Italy. marco.biolato@policlinicogemelli.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
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/
World J Hepatol. Apr 27, 2022; 14(4): 682-695 Published online Apr 27, 2022. doi: 10.4254/wjh.v14.i4.682
Direct oral anticoagulant administration in cirrhotic patients with portal vein thrombosis: What is the evidence?
Marco Biolato, Mattia Paratore, Luca Di Gialleonardo, Giuseppe Marrone, Antonio Grieco
Marco Biolato, Giuseppe Marrone, Antonio Grieco, Internal and Liver Transplant Medicine Unit, CEMAD, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
Marco Biolato, Mattia Paratore, Luca Di Gialleonardo, Giuseppe Marrone, Antonio Grieco, Institute of Internal Medicine, Catholic University of Sacred Heart, Rome 00168, Italy
Author contributions: Biolato M and Paratore M wrote the paper; Paratore M and Di Gialleonardo L performed literature analysis; Marrone G and Grieco A revised the paper for important intellectual content.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Marco Biolato, MD, PhD, Staff Physician, Internal and Liver Transplant Medicine Unit, CEMAD, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A Gemelli 8, Rome 00168, Italy. marco.biolato@policlinicogemelli.it
Received: March 30, 2021 Peer-review started: March 30, 2021 First decision: July 27, 2021 Revised: September 22, 2021 Accepted: April 3, 2022 Article in press: April 3, 2022 Published online: April 27, 2022 Processing time: 388 Days and 3.5 Hours
Core Tip
Core Tip: The role of anticoagulant therapy in portal vein thrombosis is still unclear, especially in partial, chronic and asymptomatic thrombosis. Vitamin K antagonists and low-molecular-weight heparin were demonstrated to be safe and effective, with a positive influence on liver function, portal hypertension and mortality. Direct oral anticoagulants are a new approach to treat portal vein thrombosis in patients with cirrhosis and have many advantages compared to classic anticoagulants, although evidence is still limited. In patients awaiting liver transplantation, dabigatran may be promising for preventing thrombosis progression because of the low rate of hepatotoxicity, predominant renal metabolism and reversibility in perioperative management.
