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Essentials    Global hemostasis tests generally indicate preserved hemostatic function in cirrhotic patients.  Here we present thromboelastography test results of 270 patients of mixed etiology.  Normal results were seen in the majority of patients, although some were hypo‐ or hypercoagulable.  Thromboelastography did not predict future bleeding, thrombosis, or risk of transplant or death.Background  New laboratory tests that measure global hemostasis indicate generally preserved hemostatic function in patients with cirrhosis. It is not known whether normal hemostatic function is maintained across various subsets of patients.    Objectives  In the present study, we investigated clot generation and clot lysis kinetics in a large group of patients with different etiologies of disease.    Patients/Methods  Blood samples of 270 patients with cirrhosis were studied using thromboelastography ( TEG ), which measures the dynamic and physical properties of clot formation and lysis in whole blood.  TEG  parameters of different subsets of the patient population were compared. Correlations with routine laboratory tests as well as clinical outcomes were explored.    Results  Overall,  TEG  parameters were normal and similar between underlying disease etiologies. A proportion of subjects showed hypocoagulable features, with the exception of patients with cholestatic cirrhosis in whom  TEG  readings showed hypercoagulable features. In all groups, K‐time, α‐Angle, and  MA  correlated well with platelet counts and fibrinogen plasma levels. After a mean follow‐up of 2 years and 11 months, 31 patients had experienced a bleeding event, 8 had developed thrombosis, and 173 patients (64%) had undergone liver transplantation and/or had died.  TEG  baseline parameters were similar between patients subdivided according to outcome.    Conclusions   TEG  parameters reflected generally preserved function of the hemostatic system in patients with cirrhosis, with hypo‐ and hypercoagulable features in subsets of patients with specific underlying disease etiologies. Abnormalities in  TEG  parameters did however not predict bleeding, thrombosis, or risk of liver transplantation and/or death.

Thromboelastography does not predict outcome in different etiologies of cirrhosis