Authors: NORTHUP, P. G.¹; SUNDARAM, V.²; FALLON, M. B.³; REDDY, K. R.⁴; BALOGUN, R. A.⁵; SANYAL, A. J.⁶; ANSTEE, Q. M.⁷; HOFFMAN, M. R.⁸; IKURA, Y.⁹; CALDWELL, S. H.¹

Source: Journal of Thrombosis and Haemostasis, Volume 6, Number 1, January 2008 , pp. 2-9(8)

Publisher: Wiley-Blackwell

Abstract:

Summary. 

A complex balance exists between endogenous procoagulants and the anticoagulant system in liver disease patients. Hypercoagulable events occur in cirrhosis patients despite the well-known bleeding diathesis of liver disease. These events may be clinically evident, such as in portal vein thrombosis or pulmonary embolism, but these conditions may also be a silent contributor to certain disease states, such as portopulmonary hypertension or parenchymal extinction with liver atrophy as well as thrombosis of extracorporeal circuits in dialysis or liver assist devices. Moreover, liver disease-related hypercoagulability may contribute to vascular disease in the increasingly common condition of non-alcoholic fatty liver disease. Despite the incidence of these problems, there are few widely accessible and practical laboratory tests to evaluate the risk of a hypercoagulable event in cirrhosis patients. Furthermore, there is little research on the use of commonly accepted anticoagulants in patients with liver disease. This article is a result of an international symposium on coagulation disorders in liver disease and addresses several areas of specific interest in hypercoagulation in liver disease. Critical areas lacking clinical information are highlighted and future areas of research interest are defined with an aim to foster clinical research in this field.

Keywords: blood coagulation disorders; blood coagulation tests; cirrhosis; coagulation factors; portal vein thrombosis; venous thrombosis

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1538-7836.2007.02772.x

Affiliations: 1: Division of Gastroenterology and Hepatology 2: Department of Internal Medicine, University of Virginia Health System, Charlottesville, VA 3: Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, AL 4: Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA 5: Division of Nephrology, University of Virginia Health System, Charlottesville, VA 6: Division of Gastroenterology and Hepatology, Virginia Commonwealth University, Richmond, VA, USA 7: Department of Medicine A, St Mary's Campus, Imperial College, London, UK 8: Department of Pathology, Duke University Medical Center, North Carolina, USA 9: Department of Pathology, Osaka City University, Osaka, Japan

Publication date: 2008-01-01

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