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Semin Thromb Hemost 2015; 41(05): 447-454
DOI: 10.1055/s-0035-1550435
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Coagulation in Liver Disease

Maureane Hoffman
1   Pathology and Laboratory Medicine Service, Durham Veterans Affairs Medical Center, Durham, North Carolina
2   Department of Pathology, Duke University Medical Center, Durham, North Carolina
› Author Affiliations
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Publication History

Publication Date:
06 June 2015 (online)

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Abstract

The liver plays a key role in hemostasis as the site of synthesis of many of the proteins involved in the coagulation, antithrombotic and fibrinolytic systems that interact to both establish hemostasis, and preventing thrombosis. The common laboratory tests, prothrombin time (PT) and activated partial thromboplastin time (aPTT), evolved from studies of plasma clotting in test tubes. Such studies laid the basis for the coagulation cascade model of hemostasis. However, thought has evolved to place a greater emphasis on the active roles of cells in localizing and regulating hemostasis. The PT and aPTT do not reflect the roles of cellular elements in hemostasis, nor do they reflect the crucial roles of antithrombotic and fibrinolytic systems. Thus, though the PT may indeed reflect the synthetic capacity of the liver, it does not accurately reflect the risk of bleeding or thrombosis in patients with liver failure.

Keywords

cirrhosis - thrombin generation - prothrombin time - fibrinolysis
 

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