Anticoagulation outcomes in cirrhotic patients with portal vein thrombosis: a tertiary center study

DOAC in treating PVT among patients with liver cirrhosis, demonstrating better significant survival rate when compared to traditional anticoagulation. Key message What is already known on this topic Portal vein thrombosis (PVT) is significantly more prevalent in patients with liver cirrhosis compared to the general population, posing substantial management challenges. Previous studies have primarily focused on small cohorts and retrospective data, underscoring the need for robust, large-scale analyses to validate the efficacy and safety of direct oral anticoagulants (DOACs) versus traditional therapies. What this study adds This study provides concrete evidence from a large cohort that DOACs not only offer a survival benefit over traditional anticoagulation therapies like Warfarin and LMWH in cirrhotic patients with PVT but also maintain comparable safety profiles. These findings bridge significant gaps in current research by comparing the outcomes of modern versus traditional anticoagulant approaches in a real-world setting. How this study might affect research, practice, or policy The results advocate for the inclusion of DOACs in clinical guidelines for managing PVT in cirrhosis, potentially shifting clinical practice toward these agents. Furthermore, the detailed comparison and subgroup analyses provide a strong foundation for future randomized controlled trials, which could further refine anticoagulation strategies in this high-risk population.