Hemostasis and thrombosis in patients with liver disease: The ups and downs

Abstract Patients with chronic or acute liver failure frequently show profound abnormalities in their hemostatic system. Whereas routine laboratory tests of hemostasis suggest these hemostatic alterations result in a bleeding diathesis, accumulating evidence from both clinical and laboratory studies...

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Bibliographic Details
Published in:Journal of hepatology 2010-08, Vol.53 (2), p.362-371
Main Authors: Lisman, Ton, Caldwell, Stephen H, Burroughs, Andrew K, Northup, Patrick G, Senzolo, Marco, Stravitz, R. Todd, Tripodi, Armando, Trotter, James F, Valla, Dominique-Charles, Porte, Robert J
Format: Article
Language:English
Subjects:
Bleeding
Gastroenterology and Hepatology
Hemorrhage - epidemiology
Hemorrhage - etiology
Hemorrhage - physiopathology
Hemostasis
Hemostasis - physiology
Humans
Liver disease
Liver Diseases - complications
Liver Diseases - physiopathology
Non-alcoholic steatohepatitis
Platelet
Risk Factors
Thrombin
Thrombosis
Thrombosis - epidemiology
Thrombosis - etiology
Thrombosis - physiopathology
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Summary:Abstract Patients with chronic or acute liver failure frequently show profound abnormalities in their hemostatic system. Whereas routine laboratory tests of hemostasis suggest these hemostatic alterations result in a bleeding diathesis, accumulating evidence from both clinical and laboratory studies suggest that the situation is more complex. The average patient with liver failure may be in hemostatic balance despite prolonged routine coagulation tests, since both pro- and antihemostatic factors are affected, the latter of which are not well reflected in routine coagulation testing. However, this balance may easily tip towards a hypo- or hypercoagulable situation. Indeed, patients with liver disease may encounter both hemostasis-related bleeding episodes as well as thrombotic events. During the 3rd International Symposium on Coagulopathy and Liver disease, held in Groningen, The Netherlands (18–19 September 2009), a multidisciplinary panel of experts critically reviewed the current data concerning pathophysiology and clinical consequences of hemostatic disorders in patients with liver disease. Highlights of this symposium are summarized in this review.
ISSN:0168-8278
1600-0641
DOI:10.1016/j.jhep.2010.01.042