Routine Use of Vitamin K in the Treatment of Cirrhosis-Related Coagulopathy: Is it A-O-K? Maybe Not, We Say.

Abstract

Historically, coagulopathy related to cirrhosis has been managed primarily as a bleeding disorder. However, several recent studies have shown that patients with cirrhosis have an increased risk of both bleeding and clotting. These coagulopathic changes are a result of the decreased synthetic capabilities of the cirrhotic liver. Vitamin K is often given to correct prolonged prothrombin times (PT) in patients with cirrhosis. However, this practice is not well defined and its effectiveness is questionable. The objective of our literature review is to determine the effectiveness of vitamin K to correct coagulopathy in cirrhosis. This report evaluates data published between 1981 and 2017. Published articles relevant to vitamin K use in cirrhotic patients were reviewed and summarized. The available literature regarding the use of vitamin K in cirrhosis is limited, and the research published so far does not appear to support its use. The routine uses of vitamin K to correct PT/international normalized ratio in hepatic cirrhosis should be avoided unless further studies can demonstrate true clinical benefit.