{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T10:18:40Z","timestamp":1778062720913,"version":"3.51.4"},"reference-count":69,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The objective of this study was to map and synthesize the current evidence on hemostasis in chronic and acute liver disease within the framework of Patient Blood Management (PBM). Methods: Because research in this field is heterogeneous\u2014spanning mechanistic studies, observational data, randomized controlled trials, guidelines, and expert reviews\u2014a scoping review was selected to comprehensively map concepts. Findings were synthesized narratively to reflect the breadth and heterogeneity of available research. Results: Hemostasis in liver disease is characterized by a fragile state of rebalanced coagulation, where parallel reductions in pro- and anticoagulant factors coexist with variable fibrinolytic disturbances and thrombocytopenia. Conventional coagulation tests (CCTs) do not accurately reflect bleeding risk, whereas viscoelastic assays and thrombomodulin-modified thrombin generation testing provide a more physiologic assessment, though with limitations. Most bleeding events arise from portal hypertension rather than coagulopathy, and the routine prophylactic correction of abnormal results of CCTs is not supported by evidence. PBM-aligned strategies\u2014such as restrictive transfusion, targeted fibrinogen replacement, and use of thrombopoietin receptor agonists (TPO-RAs)\u2014reduce unnecessary blood product use. Thrombosis burden is increasingly recognized in this patient population. Anticoagulation is generally safe when individualized to liver function and clinical context, however significant variability persists in clinical practice, and high-quality data remain limited for advanced disease. Conclusions: Hemostasis in liver disease reflects a dynamic and unstable equilibrium rather than a simple bleeding tendency. Diagnostic and therapeutic strategies grounded in PBM principles improve safety by avoiding unnecessary transfusion and emphasize individualized care. Despite advances in understanding rebalanced hemostasis, major gaps remain in predicting thrombotic risk, standardizing advanced coagulation testing, and defining optimal management across disease stages.<\/jats:p>","DOI":"10.3390\/jcm15093296","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:55:39Z","timestamp":1777370139000},"page":"3296","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemostasis in Liver Disease Within Patient Blood Management: A Scoping Review of the Current Literature"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4347-5631","authenticated-orcid":false,"given":"Piotr F.","family":"Czempik","sequence":"first","affiliation":[{"name":"Department of Patient Blood Management, Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"},{"name":"Transfusion Committee, University Clinical Center of Medical University of Silesia in Katowice, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2374-7894","authenticated-orcid":false,"given":"Micha\u0142","family":"Ga\u0142uszewski","sequence":"additional","affiliation":[{"name":"Student Scientific Society, Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8772-1842","authenticated-orcid":false,"given":"Jan","family":"Olszewski","sequence":"additional","affiliation":[{"name":"Student Scientific Society, Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4343-7731","authenticated-orcid":false,"given":"Seweryn","family":"Kaczara","sequence":"additional","affiliation":[{"name":"Student Scientific Society, Department of Anesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2650","DOI":"10.1016\/j.cgh.2019.07.060","article-title":"Contemporary Epidemiology of Chronic Liver Disease and Cirrhosis","volume":"18","author":"Moon","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1002\/cld.1061","article-title":"Global Epidemiology of Chronic Liver Disease","volume":"17","author":"Cheemerla","year":"2021","journal-title":"Clin. Liver Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"goae069","DOI":"10.1093\/gastro\/goae069","article-title":"Current epidemiology of chronic liver disease","volume":"12","author":"Manikat","year":"2024","journal-title":"Gastroenterol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/S2468-1253(23)00438-7","article-title":"Pathophysiology and therapeutic options for cirrhotic portal hypertension","volume":"9","year":"2024","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1016\/S0140-6736(15)00309-8","article-title":"Acute-on-chronic liver failure","volume":"386","author":"Bernal","year":"2015","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.14309\/ajg.0000000000002340","article-title":"Acute Liver Failure Guidelines","volume":"118","author":"Shingina","year":"2023","journal-title":"Am. J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/S0140-6736(24)00693-7","article-title":"Acute liver failure","volume":"404","author":"Maiwall","year":"2024","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1080\/17520363.2024.2395245","article-title":"Interaction between coagulation and inflammatory system in liver disease: Re-focus on hematological markers","volume":"18","author":"Lu","year":"2024","journal-title":"Biomark. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.4254\/wjh.v16.i9.1229","article-title":"Hematological abnormalities in liver cirrhosis","volume":"16","year":"2024","journal-title":"World J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.4254\/wjh.v14.i7.1421","article-title":"Effect of thrombocytopenia and platelet transfusion on outcomes of acute variceal bleeding in patients with chronic liver disease","volume":"14","author":"Biswas","year":"2022","journal-title":"World J. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"van Dievoet, M.A., Eeckhoudt, S., and Stephenne, X. (2020). Primary Hemostasis in Chronic Liver Disease and Cirrhosis: What Did We Learn over the Past Decade?. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21093294"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1097\/HEP.0000000000000349","article-title":"The evolving knowledge on primary hemostasis in patients with cirrhosis: A comprehensive review","volume":"79","author":"Zanetto","year":"2024","journal-title":"Hepatology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"102841","DOI":"10.1016\/j.jceh.2025.102841","article-title":"Hyperfibrinolysis: An Underrecognized Cause of Bleeding in Cirrhosis","volume":"15","author":"Hrudya","year":"2025","journal-title":"J. Clin. Exp. Hepatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2396","DOI":"10.1111\/jth.13863","article-title":"Soluble fibrin causes an acquired platelet glycoprotein VI signaling defect: Implications for coagulopathy","volume":"15","author":"Lee","year":"2017","journal-title":"J. Thromb. Haemost."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1002\/hep.28853","article-title":"Low-grade endotoxemia and platelet activation in cirrhosis","volume":"65","author":"Raparelli","year":"2017","journal-title":"Hepatology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1002\/hep.30561","article-title":"Lusutrombopag for the Treatment of Thrombocytopenia in Patients with Chronic Liver Disease Undergoing Invasive Procedures (L-PLUS 2)","volume":"70","author":"Simon","year":"2019","journal-title":"Hepatology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1016\/j.jhep.2010.08.018","article-title":"Platelet production and destruction in liver cirrhosis","volume":"54","author":"Pradella","year":"2011","journal-title":"J. Hepatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1111\/j.1538-7836.2010.04127.x","article-title":"More on: Enhanced thrombin generation in patients with cirrhosis-induced coagulopathy","volume":"9","author":"Tripodi","year":"2010","journal-title":"J. Thromb. Haemost."},{"key":"ref_19","first-page":"155","article-title":"Current Management of thrombocytopenia in chronic liver disease","volume":"15","author":"Brown","year":"2019","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1111\/jth.13278","article-title":"Procoagulant changes in fibrin clot structure in patients with cirrhosis are associated with oxidative modifications of fibrinogen","volume":"14","author":"Hugenholtz","year":"2016","journal-title":"J. Thromb. Haemost."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1007\/s12072-020-10093-3","article-title":"Thromboelastometry in patients with advanced chronic liver disease stratified by severity of portal hypertension","volume":"14","author":"Raeven","year":"2020","journal-title":"Hepatol. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/jth.15112","article-title":"Global hemostatic status in patients with acute-on-chronic liver failure and septics without underlying liver disease","volume":"19","author":"Lisman","year":"2020","journal-title":"J. Thromb. Haemost."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1875","DOI":"10.1016\/j.chest.2021.04.036","article-title":"Safety of thoracentesis and tube thoracostomy in patients with uncorrected coagulopathy: A Systematic review and meta-analysis","volume":"160","author":"Fong","year":"2021","journal-title":"Chest"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Park, S.B., Jeon, J.W., and Shin, H.P. (2023). The Risk of endoscopy-related bleeding in patients with liver cirrhosis: A retrospective study. Medicina, 59.","DOI":"10.3390\/medicina59010170"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1016\/j.cgh.2019.07.051","article-title":"Perioperative Evaluation and Management of Patients with Cirrhosis: Risk Assessment, Surgical Outcomes, and Future Directions","volume":"18","author":"Newman","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1055\/a-1667-7293","article-title":"Prevalence of Bleeding and Thrombosis in Critically Ill Patients with Chronic Liver Disease","volume":"122","author":"Ow","year":"2022","journal-title":"Thromb. Haemost."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1111\/jth.15364","article-title":"Treatment of bleeding in patients with liver disease","volume":"19","author":"Northup","year":"2021","journal-title":"J. Thromb. Haemost."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1002\/hep.31767","article-title":"Coagulopathy, Bleeding Events, and Outcome According to Rotational Thromboelastometry in Patients with Acute Liver Injury\/Failure","volume":"74","author":"Stravitz","year":"2021","journal-title":"Hepatology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1002\/hep.31507","article-title":"VWF\/ADAMTS13 Imbalance, But Not Global Coagulation or Fibrinolysis, Is Associated with Outcome and Bleeding in Acute Liver Failure","volume":"73","author":"Driever","year":"2021","journal-title":"Hepatology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/j.jhep.2024.12.008","article-title":"Impaired whole blood thrombin generation is associated with procedure-related bleeding in acutely decompensated cirrhosis","volume":"82","author":"Zanetto","year":"2025","journal-title":"J. Hepatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1053\/j.gastro.2023.05.046","article-title":"Procedural-Related Bleeding in Hospitalized Patients with Liver Disease (PROC-BLeeD): An International, Prospective, Multicenter Observational Study","volume":"165","author":"Intagliata","year":"2023","journal-title":"Gastroenterology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1111\/liv.13712","article-title":"Acute kidney injury, but not sepsis, is associated with higher procedure-related bleeding in patients with decompensated cirrhosis","volume":"38","author":"Hung","year":"2018","journal-title":"Liver Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"5290","DOI":"10.1007\/s10620-021-07376-6","article-title":"Viscoelastic Testing Prior to Non-surgical Procedures Reduces Blood Product Use Without Increasing Bleeding Risk in Cirrhosis","volume":"67","author":"Shenoy","year":"2022","journal-title":"Dig. Dis. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"102409","DOI":"10.1016\/j.jceh.2024.102409","article-title":"Rotational Thromboelastometry Reduces the Need for Preemptive Transfusion in Cirrhosis: A Randomized Controlled Trial (NCT:05698134)","volume":"15","author":"Kumar","year":"2025","journal-title":"J. Clin. Exp. Hepatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"101116","DOI":"10.1016\/j.jhepr.2024.101116","article-title":"Direct oral anticoagulants in cirrhosis: Rationale and current evidence","volume":"6","author":"Gautier","year":"2024","journal-title":"JHEP Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e0147","DOI":"10.1097\/HC9.0000000000000147","article-title":"Wide variation in pre-procedural blood product transfusion practices in cirrhosis: A national multidisciplinary survey","volume":"7","author":"Janko","year":"2023","journal-title":"Hepatol. Commun."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/EJA.0000000000001803","article-title":"Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care: Second update 2022","volume":"40","author":"Kietaibl","year":"2023","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2022). EASL Clinical Practice Guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis. J. Hepatol., 76, 1151\u20131184.","DOI":"10.1016\/j.jhep.2021.09.003"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.jhep.2019.09.008","article-title":"Fresh frozen plasma transfusion in patients with cirrhosis and coagulopathy: Effect on conventional coagulation tests and thrombomodulin-modified thrombin generation","volume":"72","author":"Rassi","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_40","first-page":"48","article-title":"No bleeding complications during major surgery in a subacute liver dysfunction patient with international normalized ratio in the therapeutic range","volume":"55","author":"Czempik","year":"2024","journal-title":"Acta Haematol. Pol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"102666","DOI":"10.1016\/j.rpth.2024.102666","article-title":"Histologic evidence of neutrophil extracellular traps and fibrin(ogen) deposition in liver biopsies from patients with inflammatory liver disease","volume":"9","author":"Lisman","year":"2025","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_42","first-page":"1901","article-title":"Fresh frozen plasma transfusion in acute variceal haemorrhage: Results from a multicentre cohort study","volume":"41","author":"Mohanty","year":"2021","journal-title":"Liver Int. Off. J. Int. Assoc. Study Liver"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"4925","DOI":"10.1038\/s41598-024-54379-0","article-title":"Efficacy of fresh frozen plasma transfusion in decompensated cirrhosis patients with coagulopathy admitted to ICU: A retrospective cohort study from MIMIC-IV database","volume":"14","author":"Fu","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Hartmann, M., Walde, C., Dirkmann, D., and Saner, F.H. (2019). Safety of coagulation factor concentrates guided by ROTEMTM-analyses in liver transplantation: Results from 372 procedures. BMC Anesthesiol., 19.","DOI":"10.1186\/s12871-019-0767-x"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1080\/03007995.2021.2012964","article-title":"Relationship between baseline clinical characteristics and efficacy of lusutrombopag in thrombocytopenic patients with chronic liver disease: Post hoc analysis of two placebo-controlled phase 3 trials","volume":"38","author":"Tanaka","year":"2022","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1111\/hepr.13530","article-title":"Thrombopoietin receptor agonist is more effective than platelet transfusion for chronic liver disease with thrombocytopenia, shown by propensity score matching","volume":"50","author":"Furuichi","year":"2020","journal-title":"Hepatol. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1111\/hepr.13755","article-title":"Phase 2 study of avatrombopag in Japanese patients with chronic liver disease and thrombocytopenia","volume":"52","author":"Eguchi","year":"2022","journal-title":"Hepatol. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"5421632","DOI":"10.1155\/2020\/5421632","article-title":"Avatrombopag, an Alternate Treatment Option to Reduce Platelet Transfusions in Patients with Thrombocytopenia and Chronic Liver Disease-Integrated Analyses of 2 Phase 3 Studies","volume":"2020","author":"Poordad","year":"2020","journal-title":"Int. J. Hepatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/jgh.14786","article-title":"Role of severe thrombocytopenia in preventing platelet count recovery in thrombocytopenic patients with chronic liver disease","volume":"35","author":"Hirooka","year":"2020","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"9228","DOI":"10.1097\/JS9.0000000000002899","article-title":"The application of avatrombopag in chronic liver disease patients with severe thrombocytopenia undergoing procedures in China: A prospective real-world cohort study","volume":"111","author":"Xiao","year":"2025","journal-title":"Int. J. Surg."},{"key":"ref_51","first-page":"857","article-title":"Portal vein thrombosis in liver cirrhosis: A review of risk factors and predictive indicators","volume":"13","author":"Yang","year":"2025","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1002\/hep.27546","article-title":"Causes and consequences of portal vein thrombosis in 1243 patients with cirrhosis: Results of a longitudinal study","volume":"61","author":"Nery","year":"2015","journal-title":"Hepatology"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/liv.15325","article-title":"Incidence and outcomes of thromboembolic and bleeding events in patients with liver cirrhosis in the USA","volume":"43","author":"Huang","year":"2023","journal-title":"Liver Int."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.jhep.2022.09.005","article-title":"Severity of systemic inflammation is the main predictor of ACLF and bleeding in individuals with acutely decompensated cirrhosis","volume":"78","author":"Zanetto","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1016\/j.jtha.2023.03.017","article-title":"In vivo generation of thrombin in patients with liver disease without apparent evidence of activation of the intrinsic or extrinsic pathway of coagulation","volume":"21","author":"Elvers","year":"2023","journal-title":"J. Thromb. Haemost."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1016\/j.jhep.2025.06.035","article-title":"Rivaroxaban to prevent complications of portal hypertension in cirrhosis: The CIRROXABAN study","volume":"83","author":"Puente","year":"2025","journal-title":"J. Hepatol."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Cox, D. (2023). Sepsis\u2014It is all about the platelets. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1210219"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1182\/blood.2023021265","article-title":"Plasmin-cleaved von Willebrand factor as a biomarker for microvascular thrombosis","volume":"143","author":"Frunt","year":"2024","journal-title":"Blood"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"103166","DOI":"10.1016\/j.rpth.2025.103166","article-title":"Plasmin-mediated proteolysis of von Willebrand factor in patients with acute and chronic liver disease","volume":"9","author":"Stamouli","year":"2025","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"100197","DOI":"10.1016\/j.iliver.2025.100197","article-title":"From thrombosis to transplantation: The role of anti-phospholipid antibodies in liver disease management","volume":"4","author":"Pallotta","year":"2025","journal-title":"ILIVER"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1002\/hep4.1317","article-title":"Serum albumin is inversely associated with portal vein thrombosis in cirrhosis","volume":"3","author":"Basili","year":"2019","journal-title":"Hepatol. Commun."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1055\/s-0038-1676981","article-title":"Incidence and recurrence of portal vein thrombosis in cirrhotic patients","volume":"119","author":"Violi","year":"2019","journal-title":"Thromb. Haemost."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e70272","DOI":"10.1111\/liv.70272","article-title":"Completely Occlusive Portal Vein Thrombosis as a Predictor of Mortality in Acute Variceal Bleeding","volume":"45","author":"Wang","year":"2025","journal-title":"Liver Int."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Lin, C., and Huang, Y. (2025). Portal vein thrombosis and Esophageal-Gastric variceal bleeding in cirrhosis: Shared risk factors and causal relationship. BMC Gastroenterol., 25.","DOI":"10.1186\/s12876-025-04094-5"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1136\/pmj-2022-141915","article-title":"Safety of anticoagulation use for treatment of portal vein thrombosis in liver cirrhosis and its effect on hospital-based outcomes: An insight from a US nationwide database","volume":"99","author":"Tarar","year":"2023","journal-title":"Postgrad. Med. J."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"2653","DOI":"10.1016\/j.jtha.2024.05.023","article-title":"Anticoagulation for stroke prevention in atrial fibrillation and treatment of venous thromboembolism and portal vein thrombosis in cirrhosis: Guidance from the SSC of the ISTH","volume":"22","author":"Carlin","year":"2024","journal-title":"J. Thromb. Haemost."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Zhou, H., Wu, M., Yu, S., Xia, H., Yu, W., Huang, K., and Chen, Y. (2023). Comparison of the efficacy and safety between rivaroxaban and dabigatran in the treatment of acute portal vein thrombosis in cirrhosis. BMC Gastroenterol., 23.","DOI":"10.1186\/s12876-023-02960-8"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"265","DOI":"10.5114\/ceh.2023.130605","article-title":"Assessment of the efficiency and safety of anticoagulation therapy in patients with liver cirrhosis and atrial fibrillation","volume":"9","author":"Baylo","year":"2023","journal-title":"Clin. Exp. Hepatol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"109103","DOI":"10.1016\/j.thromres.2024.109103","article-title":"Impact of anticoagulation therapy on outcomes in patients with cirrhosis and portal vein thrombosis: A large-scale retrospective cohort study","volume":"241","author":"Niu","year":"2024","journal-title":"Thromb. 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