Venous thromboembolism and liver cirrhosis

Objective: despite the endogenous coagulopathy of cirrhosis, some patients do experience thrombophilic states. The American College of Chest Physicians failed to address the prevention and treatment of venous thromboembolism (VTE) occurring among these patients. This study aims to describe the characteristics of cirrhotics patients hospitalized in the last 15 years, and to use the experience gained. Material and method: we retrospectively reviewed all admis sions for cirrhosis in our hospital from 1992 to 2007. A total of 17 patients had non-portal venous thromboembolic disease. We recorded risk factors, epidemiological and laboratory data, throm bosis characteristics, and treatment complications. Results and conclusions: approximately 0.8% of all hospitalized patients with cirrhosis had a non-portal VTE despite the elevated INR and low platelet count. We found low serum albumin, acquired antithrombin III, protein C and protein S deficiency, presence of antiphospholipid antibodies, and hyperhomocisteine mia in blood tests. Many patients had hemorragic complications during anticoagulation therapy, and 35% needed blood transfu sions.