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The hemostatic and thrombotic complications of liver disease
Author(s) -
McMurry Hannah Stowe,
Jou Janice,
Shatzel Joseph
Publication year - 2021
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13688
Subject(s) - medicine , cirrhosis , hemostasis , von willebrand factor , pathophysiology , intensive care medicine , platelet , pathogenesis , fibrin , coagulation , liver disease , disease , gastroenterology , immunology
Abstract Hepatic cirrhosis leads to numerous hematologic derangements resulting in a complex and tenuously rebalanced hemostatic milieu. The utility of common hematologic tests including the INR and aPTT in assessing hemostatic and thrombotic risk in patients with cirrhosis is limited, and consensus on transfusion thresholds and proper management of thrombotic complications continues to evolve. This review summarizes the pathophysiology of key derangements of hemostasis including those of platelets, von Willebrand factor, pro‐ and anticoagulation factors, and fibrin. Additionally, the pathogenesis, consequences, optimal management, and prevention of major thrombotic and bleeding complications in cirrhosis arte discussed.