Anticoagulation in chronic liver disease

J Hepatol. 2017 Jun;66(6):1313-1326. doi: 10.1016/j.jhep.2017.01.006. Epub 2017 Jan 12.


In this Grand Round presentation, the case of a man with decompensated liver disease is described. He subsequently developed a fatal pulmonary embolism, which may not have occurred if he had been prescribed prophylactic anticoagulation to prevent venous thromboembolic disease. The burden of thrombotic disease in those with chronic liver disease is discussed, before a more detailed analysis of the current evidence, safety data, and clinical dilemmas regarding the use of anticoagulation in patients with chronic liver disease. Finally, the future directions within this field are explored.

Keywords: Anticoagulation; Cirrhosis; Direct oral anticoagulants; Heparin; Liver diseases; Teaching rounds; Thromboembolism; Thrombosis.

Publication types

  • Case Reports
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • End Stage Liver Disease / complications
  • End Stage Liver Disease / drug therapy*
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / drug therapy
  • Male
  • Middle Aged
  • Pulmonary Embolism / drug therapy
  • Pulmonary Embolism / etiology
  • Pulmonary Embolism / prevention & control
  • Venous Thromboembolism / drug therapy
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control


  • Anticoagulants