INFLUENCE OF HYPERFIBRINOLYSIS ON THE PROGNOSTIC VALUE OF FACTOR VII IN PATIENTS WITH LIVER INSUFFICIENCY

As the most coagulation factors are sintethized by liver cel1,patients with liver failure (LF) have low values of coagulation factors. These latter were investigated to assess their prognostic value in LF patients,but none was proved to be useful in the individual assessment of LF. A previous study showed that in fulminant hepatitis,factor VII,whose half-life is very short,was a marker of imminent death;a further investigation supported this finding in patients with chronic LF. We evaluated the influence of hyperfibrinolysis on the prognostic value of factor VII in 37 consecutive patients affected by liver cirrhosis (LC) in severe decompensated state. 16 died within 30-50 days from the hospitalization,2 1 suvived and was discharged 30-80 days from the hospitalization. Positive FDP ( >10pgr/ml;Thrombo-Wellcotest) was found in both survivors (6) and non survivors (7) patients. Factor VII activity (Mariani's method) clear-cut differentiated survivors and non survivors indipen-dently if they had or not positive FDP. Factor VII activity of non survivors was significant lower and did not overlap that of survivors. The absence of influence of hyperfibrino1ysis on the prognostic value of .factor VII further supports the importance of evaluating this clotting factor on patients with LF.