title: Anticoagulation in chronic liver disease.
abstract: 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.
authors.affiliation: Division of Digestive Diseases, Department of Surgery and Cancer, St Mary's Hospital Campus, Imperial College London, London, UK.
authors.forename: Ameet
authors.initials: A
authors.lastname: Dhar
authors.affiliation: Division of Digestive Diseases, Department of Surgery and Cancer, St Mary's Hospital Campus, Imperial College London, London, UK.
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Mullish
authors.affiliation: Division of Digestive Diseases, Department of Surgery and Cancer, St Mary's Hospital Campus, Imperial College London, London, UK. Electronic address: m.thursz@imperial.ac.uk.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Thursz
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D058625:End Stage Liver Disease / Q000150:complications / Q000188:drug therapy*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants
keywords: Anticoagulation; Cirrhosis; Direct oral anticoagulants; Heparin; Liver diseases; Teaching rounds; Thromboembolism; Thrombosis