Factor VII as a marker of hepatocellular synthetic function in liver disease

• Published in: Journal of clinical pathology 1976-11, Vol.29 (11), p.971-975
• Main Authors: Green, G, Poller, L, Thomson, J M, Dymock, I W
• Format: Article
• Language: English
• Subjects: Cholestasis - metabolism; Chronic Disease; Factor VII - biosynthesis; Humans; Liver Cirrhosis - metabolism; Liver Diseases - blood; Liver Diseases - drug therapy; Liver Diseases - metabolism; Liver Function Tests; Prothrombin Time; Vitamin K 1 - therapeutic use
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.29.11.971

Factor VII levels have been measured in 100 patients with liver disease following parenteral vitamin K1 therapy. There was good agreement between specific factor VII measurements and the one-stage prothrombin time apart from six patients with compensated cirrhosis in whom the prothrombin time was prolonged despite the presence of normal factor VII levels. A mean activity of 58% was found in patients with cirrhosis. Cirrhotic patients with features of hepatic decompensation had a significantly lower mean level of activity (40%) than the "contrast" patients with surgical obstruction of the major bile ducts (93%). Patients with chronic active liver disease had moderate depression of factor VII levels and those with non-cirrhotic liver damage had mean activities similar to the contrast group. Factor VII levels could not be correlated with BSP retention but there was a correlation with serum albumin concentration. It is concluded that the prothrombin time using Quick test with a standardized thromboplastin showing good sensitivity to factor VII, eg, the Manchester reagent (BCT), provides a reliable index of coagulability in chronic liver disease, and specific factor VII assays are not indicated.