Low Levels of Thrombin Activatable Fibrinolysis Inhibitor (TAFI) in Patients with Chronic Liver Disease

Summary

Thrombin Activatable Fibrinolysis Inhibitor (TAFI) is a 60 κD glycoprotein present in plasma that regulates fibrinolysis by limiting the amount of fibrin available for fibrinolysis by tissue plasminogen activator (t-PA). Chronic liver disease is well-known to be associated with a low-grade fibrinolytic syndrome that under the appropriate stimulus proceeds to an overt disseminated intravascular coagulopathy (DIC) with demonstrable bleeding. In the present study, TAFI activity was measured in the plasma of 74 patients with advanced liver disease, and the levels of TAFI were related to those of other important coagulation and fibrinolytic factors. TAFI levels were very low and essentially undetectable in the plasma of patients with advanced hepatocellular liver disease. No relationship with the degradation products of fibrin was evident.

Keywords

Liver disease - coagulopathy - fibrinolysis - TAFI - disseminated intravascular coagulopathy (DIC)

• References

• 1 Paramo JA, Rifon J, Fernandez J, Cuesta B, Rocha E. Thrombin activation and increased fibrinolysis in patients with chronic liver disease. Blood Coagulation & Fibrinolysis 1991; 2 (Suppl. 02) 227-30.
• 2 Mammen EF. Coagulopathies of liver disease. Clinics in Laboratory Medicine 1994; 14 (Suppl. 04) 769-80.
• 3 Mammen EF. Coagulation defects in liver disease. Medical Clinics of North America 1994; 78 (Suppl. 03) 545-54.
• 4 Mammen EF. Coagulation abnormalities in liver disease. Hematology – Oncology Clinics of North America 1992; 6 (Suppl. 06) 1247-56.
• 5 Kemkes-Matthes B, Bleyl H, Matthes KJ. Coagulation activation in liver diseases. Thrombosis Research 1991; 64 (Suppl. 02) 253-61.
• 6 Paramo JA, Rifon J, Fernandez J, Cuesta B, Rocha E. Thrombin activation and increased fibinolysis in patients with chronic liver disease. Blood Coagulation & Fibrinolysis 1991; 2 (Suppl. 02) 227-30.
• 7 Tsuzuki T, Toyama K, Nakayasu K, Iida S, Ueda M, Toizumi A. Disseminated intravascular coagulation after hepatic resection. Surgery 1990; 107 (Suppl. 02) 172-6.
• 8 van DeWater L, Carr JM, Aronson D, McDonagh J. Analysis of elevated fibrin(ogen) degradation product levels in patients with liver disease. Blood 1986; 67 (Suppl. 05) 1486-73.
• 9 Nesheim.. TAFI. Fibrinolysis & Proteolysis 1999; 13 (Suppl. 02) 72-7.
• 10 Meihers JCM, Oudijk ED, Mosnier LO, Bos R, Bouma BN, Nieuwenhuis HK, Fijnheer R. Reduced activity of TAFI (thrombin-activatable fibrinolysis inhibitor) in acute promyelocytic leukemia. British Journal of Hematology 2000; 108: 518-23.
• 11 Chetaille P, Alessi MC, Kouassi D, Morange PE, Juhan-Vague I. Plasma TAFI Antigen Variation in Healthy Subjects. Thromb Haemost 2000; 83: 902-5.