Coagulation Abnormalities in Chronic Liver Disease

Massimo Franchini; Pier Mannuccio Mannucci

doi:10.1055/a-2531-4712

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost
DOI: 10.1055/a-2531-4712

Review Article

Coagulation Abnormalities in Chronic Liver Disease

Massimo Franchini

¹Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy

,

Pier Mannuccio Mannucci

²Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico and University of Milan, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy

› Author Affiliations

Abstract

Chronic liver disease is a frequently encountered disorder and a major concern worldwide with a complex pathophysiology, which often affects the hemostatic system. Such alterations, which affect both primary and secondary hemostasis, are heterogenous, including prohemorrhagic (i.e., decreased coagulation factors, increased fibrinolysis, thrombocytopenia, and platelet dysfunction) and prothrombotic (i.e., decreased natural anticoagulants) changes. As a consequence of this unstable balance, patients with liver cirrhosis may experience both hemorrhagic complications and venous thromboembolic events, which are often unpredictable and whose management is particularly challenging for clinicians. This narrative review will address the most recent advances in the pathophysiology of key derangements of hemostasis in patients with chronic liver disease, focusing on their clinical implications and management.

Keywords

coagulation - hemostasis - liver cirrhosis - bleeding - thrombosis

Full Text

References

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