Antithrombotic treatment with direct‐acting oral anticoagulants in patients with splanchnic vein thrombosis and cirrhosis

• DOI: 10.1111/liv.13285
• Publication Date: 2016-10-25T07:52:57Z
• Authors: Andrea De Gottardi; Jonel Trebicka; Christoph Klinger; Aurélie Plessier; Susana Seijo; Benedetta Terziroli; Lorenzo Magenta; David Semela; Elisabetta Buscarini; Philippe Langlet; Jan Görtzen; Angela Puente; Beat Müllhaupt; Carmen Navascuès; Filipe Nery; Pierre Deltenre; Fanny Turon; Cornelius Engelmann; Rupen Arya; Karel Caca; Markus Peck‐Rados...; Frank W. G. Leebeek; Dominique Valla; Juan Carlos Garci...
• Keywords: Apixaban; Portal vein thrombosis

Direct-acting oral anticoagulants (DOACs) are used in patients with splanchnic vein thrombosis (SVT) and cirrhosis, but evidence for safety efficacy this setting is limited. Our aim was to identify indications reasons starting or switching DOACs report adverse effects, complications short-term outcome.Data collection including demographic information, laboratory values, treatment through the Vascular Liver Disease Interest Group Consortium.Forty-five centres (90%) of consortium completed initial eCRF. We here a series 94 from 17 centres. Thirty-six (38%) had cirrhosis. Child-Pugh score 6 (range 5-8), MELD 10.2 6-19). Indications anticoagulation were (75%), deep (5%), atrial fibrillation (14%) others (6%). rivaroxaban (83%), dabigatran (11%) apixaban Patients followed up median duration 15 months (cirrhotic) 26.5 (non-cirrhotic). Adverse events occurred 17% included one case recurrent portal five cases bleeding. Treatment stopped three cases. The major choosing no need monitoring inadequacy INR guide cirrhotic patients. Renal liver function did not change during treatment.A consistent number SVT and/or cirrhosis currently treated DOACs, which seem be effective safe. These data provide basis performing randomized clinical trials vs. low molecular weight heparin vitamin K antagonists.