Treatment of coagulopathies in severe liver disease

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Treatment of coagulopathies in severe liver disease

Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 1

Abstract

Coagulopathy in patients with severe liver disease results from multiple abnormalities in the haemostatic system. The most important is reduced plasma levels of both procoagulative and anticoagulative factors synthesized by hepatocytes and endothelial sinusoidal cells. Failing liver is responsible for impaired clearance capacity of proteins playing a role of both the activators and inhibitors of coagulation factors. Patients with severe liver disease suffer from vitamin K deficiency leading to production of abnormal clotting factors because of impaired gamma-carboxylation. Additionally, portal hypertension is responsible for reducing the number of circulating platelets. These all factors put the patients with advanced liver diseases at increased risk of bleeding or less frequently thrombotic complications. In most cases specific therapy for coagulation disturbances is needed only during bleeding or before scheduled invasive diagnostic procedures or surgeries. In this paper the role of various treatment approaches in patients with severe liver diseases and haemostatic abnormalities have been discussed with special attention paid to current recommendations.

Authors and Affiliations

Andrzej Pluta, Krzysztof Gutkowski, Marek Hartleb

Keywords

EP ID EP53746
DOI -
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