Low ADAMTS-13/VWF ratio and altered gut–liver axis predict complications of advanced chronic liver disease:a pilot study

Introduction Liver cirrhosis is characterized by a delicate balance between thrombosis and bleeding.Parenchymal extinction due to microvascular thrombosis is involved in disease progression and anticoagulant therapy with low-molecular-weight heparin has been shown to reduce the frequency of hepatic decompensation[1].Dysbiosis and bacterial translocation,which are hallmarks of liver cirrhosis,can influence the coagulation system through inflammation or by the activation of Toll-like receptors on endothelial cells and platelets[2].However,little is known about the connections between the coagulation system,the occurrence of liver cirrhosis complications,and the gut microbiome.