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Semin Liver Dis 2002; 22(1): 083-096
DOI: 10.1055/s-2002-23205
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Coagulation Disorders in Liver Disease

Lucio Amitrano1 , Maria A. Guardascione1 , Vincenzo Brancaccio2 , Antonio Balzano1
  • 1Gastroenterology Unit, A. Cardarelli Hospital, Naples, Italy
  • 2Coagulation Unit, A. Cardarelli Hospital, Naples, Italy
Further Information

Publication History

Publication Date:
27 March 2002 (online)

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ABSTRACT

The liver plays a central role in the clotting process, and acute and chronic liver diseases are invariably associated with coagulation disorders due to multiple causes: decreased synthesis of clotting and inhibitor factors, decreased clearance of activated factors, quantitative and qualitative platelet defects, hyperfibrinolysis, and accelerated intravascular coagulation. The bleeding tendency accounts for increased risk of morbidity and mortality in patients with liver disease undergoing diagnostic or therapeutic invasive procedures. Peculiar coagulation disorders are prevalent in patients with acute fatty liver of pregnancy or undergoing liver transplantation. Emerging evidence shows that sepsis further impairs hemostasis in patients with liver cirrhosis bleeding from esophageal varices. Thrombotic events, even if rare in cirrhotic patients, occur mainly in the portal and mesenteric veins. The therapeutic approach to coagulative disorders is also discussed.

KEYWORD

Liver disease - coagulation - hemostasis - bleeding

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