Selecting anticoagulant therapy in patients with cirrhosis

Patients with liver diseases have a higher risk of hemostatic disorders. Meanwhile, despite well-established opinion on low thromboses in cirrhosis, thromboembolic events cannot be totally ruled out these patients. Increased risks thrombotic and venous thromboembolism cirrhosis are accounted for by external (immobilization, surgeries, infections, comorbidities) internal factors (reduced synthesis anticoagulants, increased levels estrogens). Practically, the selection anticoagulant therapy is difficult because divergent disorders requires continuous careful monitoring hemostasis. In 2019, American Gastroenterological Association (AGA) released guidelines patients pulmonary embolism. We describe patient A management strategy was tailored to AGA guidelines, Russian Society Liver Research Fibrosis Cirrhosis Complication Diagnosis Treatment guidelines. This example successful therapy, multidisciplinary approach, dynamic evaluation all available methods hemostasis control will useful practitioners. KEYWORDS: hemostasis, thrombosis, hemorrhage, thromboembolism, embolism, thromboelastometry, anticoagulant, low-molecular-weight heparin. FOR CITATION: Arykan N.G., Shestopalov A.E., Khvorostinina E.E. et al. Selecting cirrhosis. Medical Inquiry. 2022;6(5):286–292 (in Russ.). DOI: 10.32364/2587-6821-2022-6-5-286-292.