An interesting case.
According to your words, this patient may be diagnosed with INCPH complicated with PVT and hypersplenism (PLT 40-50). You want to balance the benefit and risk of anticoagulation for such a patient. Some details should be further given before an effective discussion.
First, despite you said that the size of thrombosis was unchanged, could you please tell us the detailed extension and grade of PVT? The severity of PVT is an important factor for determining long-term anticoagulation or not.
Second, INCPH often has a good liver function and prognosis. Liver transplantation is not necessary in most of INCPH cases. Could you please tell us the detailed liver function.
Third, we do not have any evidence that PVT increases the mortality of INCPH. Similarly, we do not have any evidence that anticoagulation increases the survival of INCPH.