Published online Jan 28, 2017. doi: 10.4254/wjh.v9.i3.139
Peer-review started: April 26, 2016
First decision: July 20, 2016
Revised: October 25, 2016
Accepted: December 13, 2016
Article in press: December 14, 2016
Published online: January 28, 2017
Core tip: Non-alcoholic steatohepatitis (NASH) is increasing in prevalence and is expected to be the leading indication for liver transplantation in the foreseeable future. There is a growing body of evidence supporting the clinical importance of a thrombophilic state in patients with NASH. In NASH patients, the most severe hypercoagulable environment is found in patients with NASH cirrhosis. High-risk NASH patients (concomitant age > 60 years, obesity, diabetes and hypertension) have inferior post transplantation outcomes, however, how this group’s risk of clotting compares to other etiologies of liver disease is unknown. In a retrospective nationwide United States based cohort, we provide further evidence of coagulation derangement in NASH and identify a new high-risk subtype in the high-risk NASH population. Whether or not this high-risk group may benefit from preventative anticoagulation remains unknown.