Coagulation Disorders in Liver Disease

Lucio Amitrano; Maria A. Guardascione; Vincenzo Brancaccio; Antonio Balzano

doi:10.1055/s-2002-23205

Seminars in Liver Disease, Table of Contents

Semin Liver Dis 2002; 22(1): 083-096
DOI: 10.1055/s-2002-23205

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

Abstract

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

Full Text

References

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