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Management of coagulation abnormalities in liver disease.

Authors
  • Potze, Wilma
  • Porte, Robert J
  • Lisman, Ton
Type
Published Article
Journal
Expert Review of Gastroenterology & Hepatology
Publisher
Informa UK (Taylor & Francis)
Publication Date
Jan 01, 2015
Volume
9
Issue
1
Pages
103–114
Identifiers
DOI: 10.1586/17474124.2014.934673
PMID: 24970667
Source
Medline
Keywords
License
Unknown

Abstract

Liver disease is characterized by changes in all phases of hemostasis. These hemostatic alterations were long considered to predispose patients with liver disease towards a bleeding tendency, as they are associated with prolonged conventional coagulation tests. However, these patients may also suffer from thrombotic complications, and we now know that the hemostatic system in patient with liver disease is, in fact, in a rebalanced state. In this review we discuss the concept of rebalanced hemostasis and its implications for clinical management of patients with liver disease. For instance, there is no evidence that the use of prophylactic blood product transfusion prior to invasive procedures reduces bleeding risk. Clinicians should also be aware of the possibility of thrombosis occurring in patients with a liver disease, and regular thrombosis prophylaxis should not be withheld in these patients.

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