Skip to main content

Correction of Abnormalities of Haemostasis in Chronic Liver Disease

  • Chapter
  • First Online:
  • 1367 Accesses

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

The liver plays a key role in blood coagulation being involved in both primary and secondary haemostasis (1, 2). It is the site of synthesis of all coagulation factors and their inhibitors except for von Willebrand factor (vWf) (3). Liver damage is commonly associated with impairment of coagulation, when liver function reserve is poor.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Lisman T, Leebeek FW, de Groot PG. Haemostatic abnormalities in patients with liver disease. J Hepatol 2002 Aug;37(2):280–7.

    PubMed  CAS  Google Scholar 

  2. Senzolo M, Burroughs AK. Hemostasis alterations in liver disease and liver transplantation. In: Kitchens G, Alving B, Kessler G, eds. Consultative Hemostasis and Thrombosis. Philadelphia: Saunders, 2007.

    Google Scholar 

  3. Rapaport SI. Coagulation problems in liver disease. Blood Coagul Fibrinolysis 2000 Apr;11(Suppl 1):S69–74.

    Google Scholar 

  4. Tripodi A, Salerno F, Chantarangkul V, Clerici M, Cazzaniga M, Primignani M, et al. Evidence of normal thrombin generation in cirrhosis despite abnormal conventional coagulation tests. Hepatology 2005 Mar;41(3):553–8.

    PubMed  CAS  Google Scholar 

  5. Caldwell SH, Hoffman M, Lisman T, Macik BG, Northup PG, Reddy KR, et al. Coagulation disorders and hemostasis in liver disease: pathophysiology and critical assessment of current management. Hepatology 2006 Oct;44(4):1039–46.

    PubMed  CAS  Google Scholar 

  6. Tripodi A, Primignani M, Chantarangkul V, Clerici M, Dell'era A, Fabris F, et al. Thrombin generation in patients with cirrhosis: the role of platelets. Hepatology 2006 Aug;44(2):440–5.

    PubMed  CAS  Google Scholar 

  7. Patch D, Armonis A, Sabin C, Christopoulou K, Greenslade L, McCormick A, et al. Single portal pressure measurement predicts survival in cirrhotic patients with recent bleeding. Gut 1999 Feb;44(2):264–9.

    PubMed  CAS  Google Scholar 

  8. Violl F, Basili S, Ferro D, Quintarelli C, Alessandril C, Cordova C. Association between high values of D-dimer and tissue-plasminogen activator activity and first gastrointestinal bleeding in cirrhotic patients. CALC Group. Thromb Haemost 1996 Aug;76(2):177–83.

    PubMed  CAS  Google Scholar 

  9. Goulis J, Patch D, Burroughs AK. Bacterial infection in the pathogenesis of variceal bleeding. Lancet 1999 Jan 9; 353(9147):139–42.

    PubMed  CAS  Google Scholar 

  10. Chau TN, Chan YW, Patch D, Tokunaga S, Greenslade L, Burroughs AK. Thrombelastographic changes and early rebleeding in cirrhotic patients with variceal bleeding. Gut 1998 Aug;43(2):267–71.

    PubMed  CAS  Google Scholar 

  11. Salooja N, Perry DJ. Thrombelastography. Blood Coagul Fibrinolysis 2001 Jul;12(5):327–37.

    PubMed  CAS  Google Scholar 

  12. Montalto P, Vlachogiannakos J, Cox DJ, Pastacaldi S, Patch D, Burroughs AK. Bacterial infection in cirrhosis impairs coagulation by a heparin effect: a prospective study. J Hepatol 2002 Oct;37(4):463–70.

    PubMed  CAS  Google Scholar 

  13. Perkins L, Jeffries M, Patel T. Utility of preoperative scores for predicting morbidity after cholecystectomy in patients with cirrhosis. Clin Gastroenterol Hepatol 2004 Dec;2(12):1123–8.

    PubMed  Google Scholar 

  14. Patel T. Surgery in the patient with liver disease. Mayo Clin Proc 1999 Jun;74(6):593–9.

    PubMed  CAS  Google Scholar 

  15. Friedman LS. The risk of surgery in patients with liver disease. Hepatology 1999 Jun;29(6):1617–23.

    PubMed  CAS  Google Scholar 

  16. Garrison RN, Cryer HM, Howard DA, Polk HC, Jr. Clarification of risk factors for abdominal operations in patients with hepatic cirrhosis. Ann Surg 1984 Jun;199(6):648–55.

    PubMed  CAS  Google Scholar 

  17. Tsuji K, Eguchi Y, Kodama M. Postoperative hypercoagulable state followed by hyperfibrinolysis related to wound healing after hepatic resection. J Am Coll Surg 1996 Sep;183(3):230–8.

    PubMed  CAS  Google Scholar 

  18. Meijer C, Wiezer MJ, Hack CE, Boelens PG, Wedel NI, Meijer S, et al. Coagulopathy following major liver resection: the effect of rBPI21 and the role of decreased synthesis of regulating proteins by the liver. Shock 2001 Apr;15(4):261–71.

    PubMed  CAS  Google Scholar 

  19. Ewe K. Bleeding after liver biopsy does not correlate with indices of peripheral coagulation. Dig Dis Sci 1981 May;26(5):388–93.

    PubMed  CAS  Google Scholar 

  20. Burroughs AK, Dagher L. Liver biopsy. In: Classen M, Tytgat GNJ, Lightdale CJ, eds. Gastroenterological Endoscopy. New York: Thieme, 2002; 252–9.

    Google Scholar 

  21. Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver biopsy. Hepatology 2009 Mar;49(3):1017–44.

    PubMed  Google Scholar 

  22. Ewe K. Bleeding after liver biopsy does not correlate with indices of peripheral coagulation. Dig Dis Sci 1981 May;26(5):388–93.

    PubMed  CAS  Google Scholar 

  23. Grant A, Neuberger J. Guidelines on the use of liver biopsy in clinical practice. British Society of Gastroenterology. Gut 1999 Oct;45(Suppl 4):IV1–11.

    Google Scholar 

  24. Gilmore IT, Burroughs A, Murray-Lyon IM, Williams R, Jenkins D, Hopkins A. Indications, methods, and outcomes of percutaneous liver biopsy in England and Wales: an audit by the British Society of Gastroenterology and the Royal College of Physicians of London. Gut 1995 Mar;36(3):437–41.

    PubMed  CAS  Google Scholar 

  25. Sherlock S, Dooley J. The haematology of liver disease. In: Blackwell Publishing, ed. Diseases of the Liver and Biliary System. 11 ed. England: Oxford, 2002; 47–64.

    Google Scholar 

  26. McGill DB, Rakela J, Zinsmeister AR, Ott BJ. A 21-year experience with major hemorrhage after percutaneous liver biopsy. Gastroenterology 1990 Nov;99(5):1396–400.

    PubMed  CAS  Google Scholar 

  27. Blake JC, Sprengers D, Grech P, McCormick PA, McIntyre N, Burroughs AK. Bleeding time in patients with hepatic cirrhosis. Br Med J 1990 Jul 7;301(6742):12–5.

    CAS  Google Scholar 

  28. Papatheodoridis GV, Patch D, Watkinson A, Tibballs J, Burroughs AK. Transjugular liver biopsy in the 1990s: a 2-year audit. Aliment Pharmacol Ther 1999 May;13(5):603–8.

    PubMed  CAS  Google Scholar 

  29. Pache I, Bilodeau M. Severe haemorrhage following abdominal paracentesis for ascites in patients with liver disease. Aliment Pharmacol Ther 2005 Mar 1;21(5):525–9.

    PubMed  CAS  Google Scholar 

  30. Lin CH, Chen SC, Ko PC. Preprocedure coagulation tests are unnecessary before abdominal paracentesis in emergency departments. Hepatology 2005 Feb;41(2):402–3.

    PubMed  Google Scholar 

  31. Mumtaz H, Williams V, Hauer-Jensen M, Rowe M, Henry-Tillman RS, Heaton K, et al. Central venous catheter placement in patients with disorders of hemostasis. Am J Surg 2000 Dec;180(6):503–5.

    PubMed  CAS  Google Scholar 

  32. Lee HS, Quinn T, Boyle RM. Safety of thrombolytic treatment in patients with central venous cannulation. Br Heart J 1995 Apr;73(4):359–62.

    PubMed  CAS  Google Scholar 

  33. Runyon BA. Paracentesis of ascitic fluid. A safe procedure. Arch Intern Med 1986 Nov;146(11):2259–61.

    PubMed  CAS  Google Scholar 

  34. Bernard B, Grange JD, Khac EN, Amiot X, Opolon P, Poynard T. Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis. Hepatology 1999 Jun;29(6):1655–61.

    PubMed  CAS  Google Scholar 

  35. Goulis J, Armonis A, Patch D, Sabin C, Greenslade L, Burroughs AK. Bacterial infection is independently associated with failure to control bleeding in cirrhotic patients with gastrointestinal hemorrhage. Hepatology 1998 May;27(5):1207–12.

    PubMed  CAS  Google Scholar 

  36. Bernard B, Cadranel JF, Valla D, Escolano S, Jarlier V, Opolon P. Prognostic significance of bacterial infection in bleeding cirrhotic patients: a prospective study. Gastroenterology 1995 Jun;108(6):1828–34.

    PubMed  CAS  Google Scholar 

  37. Hou MC, Lin HC, Liu TT, Kuo BI, Lee FY, Chang FY, et al. Antibiotic prophylaxis after endoscopic therapy prevents rebleeding in acute variceal hemorrhage: a randomized trial. Hepatology 2004 Mar;39(3):746–53.

    PubMed  CAS  Google Scholar 

  38. Jun CH, Park CH, Lee WS, Joo YE, Kim HS, Choi SK, et al. Antibiotic prophylaxis using third generation cephalosporins can reduce the risk of early rebleeding in the first acute gastroesophageal variceal hemorrhage: a prospective randomized study. J Korean Med Sci 2006 Oct;21(5):883–90.

    PubMed  CAS  Google Scholar 

  39. Zambruni A, Thalheimer U, Coppell J, Riddell A, Mancuso A, Leandro G, et al. Endogenous heparin-like activity detected by anti-Xa assay in infected cirrhotic and non-cirrhotic patients. Scand J Gastroenterol 2004 Sep;39(9):830–6.

    PubMed  CAS  Google Scholar 

  40. Thalheimer U, Triantos C, Samonakis D, Patch D, Burroughs AK, Riddell A, et al. Endogenous heparinoids in acute variceal bleeding. Gut 2005 Feb;54(2):310–1.

    PubMed  CAS  Google Scholar 

  41. McKee RF, Hodson S, Dawes J, Garden OJ, Carter DC. Plasma concentrations of endogenous heparinoids in portal hypertension. Gut 1992 Nov;33(11):1549–52.

    PubMed  CAS  Google Scholar 

  42. Thalheimer U, Triantos CK, Samonakis DN, Patch D, Burroughs AK. Infection, coagulation, and variceal bleeding in cirrhosis. Gut 2005 Apr;54(4):556–63.

    PubMed  CAS  Google Scholar 

  43. Grignani G, Maiolo A. Cytokines and hemostasis. Haematologica 2000 Sep;85(9):967–72.

    PubMed  CAS  Google Scholar 

  44. Violi F, Ferro D, Basili S, Saliola M, Quintarelli C, Alessandri C, et al. Association between low-grade disseminated intravascular coagulation and endotoxemia in patients with liver cirrhosis. Gastroenterology 1995 Aug;109(2):531–9.

    PubMed  CAS  Google Scholar 

  45. Plessier A, Denninger MH, Consigny Y, Pessione F, Francoz C, Durand F, et al. Coagulation disorders in patients with cirrhosis and severe sepsis. Liver Int 2003 Dec;23(6):440–8.

    PubMed  Google Scholar 

  46. Wong F, Bernardi M, Balk R, Christman B, Moreau R, Garcia-Tsao G, et al. Sepsis in cirrhosis: report on the 7th meeting of the International Ascites Club. Gut 2005 May;54(5):718–25.

    PubMed  CAS  Google Scholar 

  47. Jun CH, Park CH, Lee WS, Joo YE, Kim HS, Choi SK, et al. Antibiotic prophylaxis using third generation cephalosporins can reduce the risk of early rebleeding in the first acute gastroesophageal variceal hemorrhage: a prospective randomized study. J Korean Med Sci 2006 Oct;21(5):883–90.

    PubMed  CAS  Google Scholar 

  48. Ruiz-del-Arbol L, Urman J, Fernandez J, Gonzalez M, Navasa M, Monescillo A, et al. Systemic, renal, and hepatic hemodynamic derangement in cirrhotic patients with spontaneous bacterial peritonitis. Hepatology 2003 Nov;38(5):1210–8.

    PubMed  Google Scholar 

  49. Vlachogiannakos J, Saveriadis AS, Viazis N, Theodoropoulos I, Foudoulis K, Manolakopoulos S, et al. Intestinal decontamination improves liver haemodynamics in patients with alcohol-related decompensated cirrhosis. Aliment Pharmacol Ther 2009 May 1;29(9):992–9.

    PubMed  CAS  Google Scholar 

  50. Bayly PJ, Thick M. Reversal of post-reperfusion coagulopathy by protamine sulphate in orthotopic liver transplantation. Br J Anaesth 1994 Dec;73(6):840–2.

    PubMed  CAS  Google Scholar 

  51. Stafford-Smith M, Lefrak EA, Qazi AG, Welsby IJ, Barber L, Hoeft A, et al. Efficacy and safety of heparinase I versus protamine in patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass. Anesthesiology 2005 Aug;103(2):229–40.

    PubMed  CAS  Google Scholar 

  52. Lucena MI, Andrade RJ, Tognoni G, Hidalgo R, De La Cuesta FS. Multicenter hospital study on prescribing patterns for prophylaxis and treatment of complications of cirrhosis. Eur J Clin Pharmacol 2002 Sep;58(6):435–40.

    Google Scholar 

  53. Amitrano L, Guardascione MA, Brancaccio V, Balzano A. Coagulation disorders in liver disease. Semin Liver Dis 2002 Feb;22(1):83–96.

    PubMed  CAS  Google Scholar 

  54. Everson GT. A hepatologist's perspective on the management of coagulation disorders before liver transplantation. Liver Transpl Surg 1997 Nov;3(6):646–52.

    PubMed  CAS  Google Scholar 

  55. Martin DJ, Lucas CE, Ledgerwood AM, Hoschner J, McGonigal MD, Grabow D. Fresh frozen plasma supplement to massive red blood cell transfusion. Ann Surg 1985 Oct;202(4):505–11.

    PubMed  CAS  Google Scholar 

  56. Maltz GS, Siegel JE, Carson JL. Hematologic management of gastrointestinal bleeding. Gastroenterol Clin North Am 2000 Mar;29(1):169–87, vii.

    PubMed  CAS  Google Scholar 

  57. Mueller MM, Bomke B, Seifried E. Fresh frozen plasma in patients with disseminated intravascular coagulation or in patients with liver diseases. Thromb Res 2002 Oct 31;107(Suppl 1):S9–17.

    Google Scholar 

  58. Hadengue A, Moreau R, Gaudin C, Bacq Y, Champigneulle B, Lebrec D. Total effective vascular compliance in patients with cirrhosis: a study of the response to acute blood volume expansion. Hepatology 1992 May;15(5):809–15.

    PubMed  CAS  Google Scholar 

  59. Moller S, Bendtsen F, Henriksen JH. Effect of volume expansion on systemic hemodynamics and central and arterial blood volume in cirrhosis. Gastroenterology 1995 Dec;109(6):1917–25.

    PubMed  CAS  Google Scholar 

  60. Vlavianos P, Mac MP, Williams R, Westaby D. Splanchnic and systemic haemodynamic response to volume changes in patients with cirrhosis and portal hypertension. Clin Sci (Lond) 1999 May;96(5):475–81.

    CAS  Google Scholar 

  61. Castaneda B, Morales J, Lionetti R, Moitinho E, Andreu V, Perez-Del-Pulgar S, et al. Effects of blood volume restitution following a portal hypertensive-related bleeding in anesthetized cirrhotic rats. Hepatology 2001 Apr;33(4):821–5.

    PubMed  CAS  Google Scholar 

  62. Colomo A, Hernandez-Gea V, Muniz-Diaz E, Madoz P, Aracil C, Alvarez-Urturi C, et al. Transfusion strategies in patients with cirrhosis and acute gastrointestinal bleeding. Hepatology 2008;48(4).

    Google Scholar 

  63. Colomo A, Hernandez-Gea V, Madoz P, Aracil C, Alvarez-Urturi C, Poca M, et al. Hemodynamic changes and transfusion strategies in cirrhotic patients with acute variceal bleeding. Hepatology 2009;50(4).

    Google Scholar 

  64. Massicotte L, Sassine MP, Lenis S, Roy A. Transfusion predictors in liver transplant. Anesth Analg 2004 May;98(5):1245–51.

    PubMed  Google Scholar 

  65. Kalambokis G, Manousou P, Vibhakorn S, Marelli L, Cholongitas E, Senzolo M, et al. Transjugular liver biopsy – indications, adequacy, quality of specimens, and complications – a systematic review. J Hepatol 2007 Aug;47(2):284–94.

    PubMed  Google Scholar 

  66. Gazzard BG, Henderson JM, Williams R. The use of fresh frozen plasma or a concentrate of factor IX as replacement therapy before liver biopsy. Gut 1975 Aug;16(8):621–5.

    PubMed  CAS  Google Scholar 

  67. Mannucci PM, Franchi F, Dioguardi N. Correction of abnormal coagulation in chronic liver disease by combined use of fresh-frozen plasma and prothrombin complex concentrates. Lancet 1976 Sep 11;2(7985):542–5.

    PubMed  CAS  Google Scholar 

  68. Lorenz R, Kienast J, Otto U, Egger K, Kiehl M, Schreiter D, et al. Efficacy and safety of a prothrombin complex concentrate with two virus-inactivation steps in patients with severe liver damage. Eur J Gastroenterol Hepatol 2003 Jan;15(1):15–20.

    PubMed  CAS  Google Scholar 

  69. Gunter P. Practice guidelines for blood component therapy. Anesthesiology 1996 Nov;85(5):1219–20.

    PubMed  CAS  Google Scholar 

  70. Mammen EF. Disseminated intravascular coagulation (DIC). Clin Lab Sci 2000;13 (4):239–45.

    PubMed  CAS  Google Scholar 

  71. French CJ, Bellomo R, Angus P. Cryoprecipitate for the correction of coagulopathy associated with liver disease. Anaesth Intensive Care 2003 Aug;31(4):357–61.

    PubMed  CAS  Google Scholar 

  72. Franchini M, Montagnana M, Targher G, Zaffanello M, Lippi G. The use of recombinant factor VIIa in liver diseases. Blood Coagul Fibrinolysis 2008 Jul;19(5):341–8.

    PubMed  CAS  Google Scholar 

  73. Caldwell SH, Chang C, Macik BG. Recombinant activated factor VII (rFVIIa) as a hemostatic agent in liver disease: a break from convention in need of controlled trials. Hepatology 2004 Mar;39(3):592–8.

    PubMed  CAS  Google Scholar 

  74. Erhardtsen E, Nony P, Dechavanne M, Ffrench P, Boissel JP, Hedner U. The effect of recombinant factor VIIa (NovoSeven) in healthy volunteers receiving acenocoumarol to an International Normalized Ratio above 2.0. Blood Coagul Fibrinolysis 1998 Nov;9(8):741–8.

    PubMed  CAS  Google Scholar 

  75. Bernstein DE, Jeffers L, Erhardtsen E, Reddy KR, Glazer S, Squiban P, et al. Recombinant factor VIIa corrects prothrombin time in cirrhotic patients: a preliminary study. Gastroenterology 1997 Dec;113(6):1930–7.

    PubMed  CAS  Google Scholar 

  76. Lindley CM, Sawyer WT, Macik BG, Lusher J, Harrison JF, Baird-Cox K, et al. Pharmacokinetics and pharmacodynamics of recombinant factor VIIa. Clin Pharmacol Ther 1994 Jun;55(6):638–48.

    PubMed  CAS  Google Scholar 

  77. Jeffers L, Chalasani N, Balart L, Pyrsopoulos N, Erhardtsen E. Safety and efficacy of recombinant factor VIIa in patients with liver disease undergoing laparoscopic liver biopsy. Gastroenterology 2002 Jul;123(1):118–26.

    PubMed  CAS  Google Scholar 

  78. Lodge JP, Jonas S, Oussoultzoglou E, Malago M, Jayr C, Cherqui D, et al. Recombinant coagulation factor VIIa in major liver resection: a randomized, placebo-controlled, double-blind clinical trial. Anesthesiology 2005 Feb;102(2):269–75.

    PubMed  CAS  Google Scholar 

  79. Shao YF, Yang JM, Chau GY, Sirivatanauksorn Y, Zhong SX, Erhardtsen E, et al. Safety and hemostatic effect of recombinant activated factor VII in cirrhotic patients undergoing partial hepatectomy: a multicenter, randomized, double-blind, placebo-controlled trial. Am J Surg 2006 Feb;191(2):245–9.

    PubMed  CAS  Google Scholar 

  80. Chuansumrit A, Treepongkaruna S, Phuapradit P. Combined fresh frozen plasma with recombinant factor VIIa in restoring hemostasis for invasive procedures in children with liver diseases. Thromb Haemost 2001 Apr;85 (4):748–9.

    PubMed  CAS  Google Scholar 

  81. Bosch J, Thabut D, Bendtsen F, D’Amico G, Albillos A, Gonzalez AJ, et al. Recombinant factor VIIa for upper gastrointestinal bleeding in patients with cirrhosis: a randomized, double-blind trial. Gastroenterology 2004 Oct;127(4):1123–30.

    PubMed  CAS  Google Scholar 

  82. Bosch J, Thabut D, Albillos A, Carbonell N, Spicak J, Massard J, et al. Recombinant factor VIIa for variceal bleeding in patients with advanced cirrhosis: a randomized, controlled trial. Hepatology 2008 May;47(5):1604–14.

    Google Scholar 

  83. Ejlersen E, Melsen T, Ingerslev J, Andreasen RB, Vilstrup H. Recombinant activated factor VII (rFVIIa) acutely normalizes prothrombin time in patients with cirrhosis during bleeding from oesophageal varices. Scand J Gastroenterol 2001 Oct;36(10):1081–5.

    PubMed  CAS  Google Scholar 

  84. Romero-Castro R, Jimenez-Saenz M, Pellicer-Bautista F, Gomez-Parra M, Arguelles AF, Guerrero-Aznar MD, et al. Recombinant-activated factor VII as hemostatic therapy in eight cases of severe hemorrhage from esophageal varices. Clin Gastroenterol Hepatol 2004 Jan;2(1):78–84.

    PubMed  CAS  Google Scholar 

  85. Shapiro SS. Treating thrombosis in the 21st century. N Engl J Med 2003 Oct 30;349(18):1762–4.

    PubMed  CAS  Google Scholar 

  86. Bergqvist D, Arfors KE. The effect of normovolemic hemodilution on microvascular hemostasis in the rabbit. Res Exp Med (Berl) 1979 Apr 23;175(1):61–6.

    CAS  Google Scholar 

  87. Afdhal NH, McHutchison JG. Review article: pharmacological approaches for the treatment of thrombocytopenia in patients with chronic liver disease and hepatitis C infection. Aliment Pharmacol Ther 2007 Nov;26(Suppl 1):29–39.

    PubMed  CAS  Google Scholar 

  88. Artz AS, Ershler WB, Rustgi V. Interleukin-11 for thrombocytopenia associated with hepatitis C. J Clin Gastroenterol 2001 Nov;33(5):425–6.

    PubMed  CAS  Google Scholar 

  89. McHutchison JG, Dusheiko G, Shiffman ML, Rodriguez-Torres M, Sigal S, Bourliere M, et al. Eltrombopag for thrombocytopenia in patients with cirrhosis associated with hepatitis C. N Engl J Med 2007 Nov 29;357 (22):2227–36.

    PubMed  CAS  Google Scholar 

  90. Bolognesi M, Merkel C, Sacerdoti D, Nava V, Gatta A. Role of spleen enlargement in cirrhosis with portal hypertension. Dig Liver Dis 2002 Feb;34(2):144–50.

    PubMed  CAS  Google Scholar 

  91. N’Kontchou G, Seror O, Bourcier V, Mohand D, Ajavon Y, Castera L, et al. Partial splenic embolization in patients with cirrhosis: efficacy, tolerance and long-term outcome in 32 patients. Eur J Gastroenterol Hepatol 2005 Feb;17(2):179–84.

    PubMed  Google Scholar 

  92. Jabbour N, Zajko A, Orons P, Irish W, Fung JJ, Selby RR. Does transjugular intrahepatic portosystemic shunt (TIPS) resolve thrombocytopenia associated with cirrhosis? Dig Dis Sci 1998 Nov;43 (11):2459–62.

    PubMed  CAS  Google Scholar 

  93. Karasu Z, Gurakar A, Kerwin B, Hulagu S, Jazzar A, McFadden R, et al. Effect of transjugular intrahepatic portosystemic shunt on thrombocytopenia associated with cirrhosis. Dig Dis Sci 2000 Oct;45 (10):1971–6.

    PubMed  CAS  Google Scholar 

  94. Mannucci PM, Canciani MT, Rota L, Donovan BS. Response of factor VIII/von Willebrand factor to DDAVP in healthy subjects and patients with haemophilia A and von Willebrand’s disease. Br J Haematol 1981 Feb;47(2):283–93.

    PubMed  CAS  Google Scholar 

  95. Burroughs AK, Matthews K, Qadiri M, Thomas N, Kernoff P, Tuddenham E, et al. Desmopressin and bleeding time in patients with cirrhosis. Br Med J (Clin Res Ed) 1985 Nov 16;291 (6506):1377–81.

    CAS  Google Scholar 

  96. de Franchis R, Arcidiacono PG, Carpinelli L, Andreoni B, Cestari L, Brunati S, et al. Randomized controlled trial of desmopressin plus terlipressin vs. terlipressin alone for the treatment of acute variceal hemorrhage in cirrhotic patients: a multicenter, double-blind study. New Italian Endoscopic Club. Hepatology 1993 Nov;18(5):1102–7.

    PubMed  Google Scholar 

  97. Wong AY, Irwin MG, Hui TW, Fung SK, Fan ST, Ma ES. Desmopressin does not decrease blood loss and transfusion requirements in patients undergoing hepatectomy. Can J Anaesth 2003 Jan;50 (1):14–20.

    PubMed  Google Scholar 

  98. Pereboom IT, de Boer MT, Porte RJ, Molenaar IQ. Aprotinin and nafamostat mesilate in liver surgery: effect on blood loss. Dig Surg 2007;24(4):282–7.

    PubMed  CAS  Google Scholar 

  99. Shore-Lesserson L. Point-of-care coagulation monitoring for cardiovascular patients: past and present. J Cardiothorac Vasc Anesth 2002 Feb;16 (1):99–106.

    PubMed  Google Scholar 

  100. Lentschener C, Benhamou D, Mercier FJ, Boyer-Neumann C, Naveau S, Smadja C, et al. Aprotinin reduces blood loss in patients undergoing elective liver resection. Anesth Analg 1997 Apr;84 (4):875–81.

    PubMed  CAS  Google Scholar 

  101. Shimada M, Matsumata T, Shirabe K, Kamakura T, Taketomi A, Sugimachi K. Effect of nafamostat mesilate on coagulation and fibrinolysis in hepatic resection. J Am Coll Surg 1994 May;178 (5):498–502.

    PubMed  CAS  Google Scholar 

  102. Sopher M, Braunfeld M, Shackleton C, Busuttil RW, Sangwan S, Csete M. Fatal pulmonary embolism during liver transplantation. Anesthesiology 1997 Aug;87 (2):429–32.

    PubMed  CAS  Google Scholar 

  103. Dalmau A, Sabate A, Acosta F, Garcia-Huete L, Koo M, Sansano T, et al. Tranexamic acid reduces red cell transfusion better than epsilon-aminocaproic acid or placebo in liver transplantation. Anesth Analg 2000 Jul;91(1):29–34.

    PubMed  CAS  Google Scholar 

  104. Wu CC, Ho WM, Cheng SB, Yeh DC, Wen MC, Liu TJ, et al. Perioperative parenteral tranexamic acid in liver tumor resection: a prospective randomized trial toward a “blood transfusion”-free hepatectomy. Ann Surg 2006 Feb;243 (2):173–80.

    PubMed  Google Scholar 

  105. Molenaar IQ, Warnaar N, Groen H, Tenvergert EM, Slooff MJ, Porte RJ. Efficacy and safety of antifibrinolytic drugs in liver transplantation: a systematic review and meta-analysis. Am J Transplant 2007 Jan;7 (1):185–94.

    PubMed  CAS  Google Scholar 

  106. McCormick PA, Ooi H, Crosbie O. Tranexamic acid for severe bleeding gastric antral vascular ectasia in cirrhosis. Gut 1998 May;42 (5):750–2.

    PubMed  CAS  Google Scholar 

  107. Egbring R, Seitz R, Blanke H, Leititis J, Kesper HJ, Burghard R, et al. The proteinase inhibitor complexes (antithrombin III–thrombin, alpha 2antiplasmin–plasmin and alpha 1antitrypsin–elastase) in septicemia, fulminant hepatic failure and cardiac shock: value for diagnosis and therapy control in DIC/F syndrome. Behring Inst Mitt 1986 Feb;(79):87–103.

    Google Scholar 

  108. Palareti G, Legnani C, Maccaferri M, Gozzetti G, Mazziotti A, Martinelli G, et al. Coagulation and fibrinolysis in orthotopic liver transplantation: role of the recipient’s disease and use of antithrombin III concentrates. S. Orsola Working Group on Liver Transplantation. Haemostasis 1991;21 (2):68–76.

    PubMed  CAS  Google Scholar 

  109. Wanless IR, Wong F, Blendis LM, Greig P, Heathcote EJ, Levy G. Hepatic and portal vein thrombosis in cirrhosis: possible role in development of parenchymal extinction and portal hypertension. Hepatology 1995 May;21 (5):1238–47.

    PubMed  CAS  Google Scholar 

  110. Amitrano L, Guardascione MA, Brancaccio V, Margaglione M, Manguso F, Iannaccone L, et al. Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J Hepatol 2004 May;40(5):736–41.

    PubMed  Google Scholar 

  111. Francoz C, Belghiti J, Vilgrain V, Sommacale D, Paradis V, Condat B, et al. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation. Gut 2005 May;54 (5):691–7.

    PubMed  CAS  Google Scholar 

  112. Senzolo M, Cholongitas CE, Patch D, Burroughs AK. Update on the classification, assessment of prognosis and therapy of Budd–Chiari syndrome. Nat Clin Pract Gastroenterol Hepatol 2005;2 (4), 182–90.

    PubMed  Google Scholar 

  113. Espiritu JD. Pulmonary embolism in a patient with coagulopathy from end-stage liver disease. Chest 2000 Mar;117 (3):924–5.

    PubMed  CAS  Google Scholar 

  114. Ben Ari Z, Panagou M, Patch D, Bates S, Osman E, Pasi J, et al. Hypercoagulability in patients with primary biliary cirrhosis and primary sclerosing cholangitis evaluated by thrombelastography. J Hepatol 1997 Mar;26 (3):554–9.

    PubMed  CAS  Google Scholar 

  115. Northup PG, McMahon MM, Ruhl AP, Altschuler SE, Volk-Bednarz A, Caldwell SH, et al. Coagulopathy does not fully protect hospitalized cirrhosis patients from peripheral venous thromboembolism. Am J Gastroenterol 2006 Jul;101 (7):1524–8.

    Google Scholar 

  116. Sogaard KK, Horvath-Puho E, Gronbaek H, Jepsen P, Vilstrup H, Sorensen HT. Risk of venous thromboembolism in patients with liver disease: a nationwide population-based case–control study. Am J Gastroenterol 2009 Jan;104 (1):96–101.

    PubMed  Google Scholar 

  117. Senzolo M, Sartori MT, Lisman T. Should we give thromboprophylaxis to patients with liver cirrhosis and coagulopathy? HPB (Oxford) 2009;11 (6):459–64.

    Google Scholar 

  118. Garcia-Fuster MJ, Abdilla N, Fabia MJ, Fernandez C, Oliver V, Corner MJ. Venous thromboembolism and liver cirrhosis. Rev Esp Enferm Dig 2008;100:259–262.

    Google Scholar 

  119. Tripodi A. How to implement the modified international normalized ratio for cirrhosis (INR(liver)) for model for end-stage liver disease calculation. Hepatology 2008 Apr;47 (4):1423–4.

    PubMed  Google Scholar 

  120. Senzolo M, Ferronato C, Burra P, Sartori MT. Anticoagulation for portal vein thrombosis in cirrhotic patients should be always considered. Intern Emerg Med 2009 Apr;4 (2):161–2.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Senzolo, M., Burroughs, A.K. (2011). Correction of Abnormalities of Haemostasis in Chronic Liver Disease. In: Ginès, P., Kamath, P., Arroyo, V. (eds) Chronic Liver Failure. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-60761-866-9_23

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-866-9_23

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-865-2

  • Online ISBN: 978-1-60761-866-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics