Download PDF
Semin Liver Dis 2002; 22(1): 083-096
DOI: 10.1055/s-2002-23205
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Coagulation Disorders in Liver Disease

Lucio Amitrano1 , Maria A. Guardascione1 , Vincenzo Brancaccio2 , Antonio Balzano1
  • 1Gastroenterology Unit, A. Cardarelli Hospital, Naples, Italy
  • 2Coagulation Unit, A. Cardarelli Hospital, Naples, Italy
Further Information

Publication History

Publication Date:
27 March 2002 (online)

    Permissions and Reprints

ABSTRACT

The liver plays a central role in the clotting process, and acute and chronic liver diseases are invariably associated with coagulation disorders due to multiple causes: decreased synthesis of clotting and inhibitor factors, decreased clearance of activated factors, quantitative and qualitative platelet defects, hyperfibrinolysis, and accelerated intravascular coagulation. The bleeding tendency accounts for increased risk of morbidity and mortality in patients with liver disease undergoing diagnostic or therapeutic invasive procedures. Peculiar coagulation disorders are prevalent in patients with acute fatty liver of pregnancy or undergoing liver transplantation. Emerging evidence shows that sepsis further impairs hemostasis in patients with liver cirrhosis bleeding from esophageal varices. Thrombotic events, even if rare in cirrhotic patients, occur mainly in the portal and mesenteric veins. The therapeutic approach to coagulative disorders is also discussed.

KEYWORD

Liver disease - coagulation - hemostasis - bleeding

REFERENCES

  • 1 Watson S P. Collagen receptor signalling in platelets and megakaryocytes.  Thromb Haemost . 1999;  82 365-376
    PubMedGoogle Scholar
  • 2 Berndt M C, Shen Y, Dopheide A M. The vascular biology of the glycoprotein Ib-IX-V complex.  Thromb Haemost . 2001;  86 178-188
    PubMedGoogle Scholar
  • 3 Savage B, Shattil S J, Ruggeri Z M. Modulation of platelet function through adhesion receptors: a dual role for glycoprotein IIb-IIIa (integrin alpha IIb beta 3) mediated by fibrinogen and glycoprotein Ib-von Willebrand factor.  J Biol Chem . 1992;  267 11300-11306
    PubMedGoogle Scholar
  • 4 Gallus A S, Lucas C R, Hirsh J. Coagulation studies in patients with acute infectious hepatitis.  Br J Haematol . 1972;  22 761-771
    PubMedGoogle Scholar
  • 5 Tzakis A G, Arditi M, Whittington P F. Aplastic anemia complicating orthotopic liver transplantation for non-A, non-B hepatitis.  N Engl J Med . 1988;  319 393-396
    CrossrefPubMedGoogle Scholar
  • 6 Lechner K, Niessner H, Thaler E. Coagulation abnormalities in liver disease.  Semin Thromb Hemost . 1977;  4 40-56
    PubMedGoogle Scholar
  • 7 Bashour F N, Teran J C, Mullen K D. Prevalence of peripheral blood cytopenias (hypersplenism) in patients with nonalcoholic chronic liver disease.  Am J Gastroenterol . 2000;  95 2936-2939
    CrossrefPubMedGoogle Scholar
  • 8 Schepis F, Cammà C, Niceforo D. Which patients with cirrhosis should undergo endoscopic screening for esophageal varices detection?.  Hepatology . 2001;  33 333-338
    CrossrefPubMedGoogle Scholar
  • 9 Zaman A, Hapke R, Flora K. Factors predicting the presence of esophageal or gastric varices in patients with advanced liver disease.  Am J Gastroenterol . 1999;  94 3292-3296
    CrossrefPubMedGoogle Scholar
  • 10 Karasu Z, Gurakar A, Kerwin B. Effect of transjugular intrahepatic portosystemic shunt on thrombocytopenia associated with cirrhosis.  Dig Dis Sci . 2000;  45 1971-1976
    CrossrefPubMedGoogle Scholar
  • 11 Koike Y, Yoneyama A, Shirai J. Evaluation of thrombopoiesis in thrombocytopenic disorders by simultaneous measurement of reticulated platelets of whole blood and serum thrombopoietin concentrations.  Thromb Haemost . 1998;  79 1106-1110
    PubMedGoogle Scholar
  • 12 Kawasaki T, Takeshita A, Souda K. Serum thrombopoietin levels in patients with chronic hepatitis and liver cirrhosis.  Am J Gastroenterol . 1999;  94 1918-1922
    CrossrefPubMedGoogle Scholar
  • 13 Peck-Radosavljevic M, Wichlas M, Zacherl J. Thrombopoietin induces rapid resolution of thrombocytopenia after orthotopic liver transplantation through increased platelet production.  Blood . 2000;  95 795-801
    PubMedGoogle Scholar
  • 14 Samuel H, Nardi M, Karpatkin M. Differentiation of autoiimune thrombocytopenia from thrombocytopenia associated with immune complex disease : systemic lupus erythematosus, hepatitis-cirrhosis, and HIV-1 infection by platelet and serum immunological measurements.  Br J Haematol . 1999;  105 1086-1091
    CrossrefPubMedGoogle Scholar
  • 15 Lindenbaum J, Hargrove R L. Thrombocytopenia in alcoholics.  Ann Intern Med . 1968;  68 526-532
    PubMedGoogle Scholar
  • 16 Lindenbaum J. Folate and vitamin B12 deficiencies in alcoholism.  Semin Hematol . 1980;  17 119-129
    PubMedGoogle Scholar
  • 17 Fattovich G, Giustina G, Favarato S. A survey of adverse events in 11,241 patients with chronic viral hepatitis treated with alfa interferon.  J Hepatol . 1996;  24 38-47
    CrossrefPubMedGoogle Scholar
  • 18 Schirren C A, Berghaus T M, Sackmann M. Thrombotic thrombocitopenic purpura after Ecstasy-induced acute liver failure.  Ann Intern Med . 1999;  130 163
    PubMedGoogle Scholar
  • 19 Ratnoff O D. Hemostatic defects in liver and biliary tract disease and disorders of vitamin k metabolism. In: Ratnoff OD, Forbes CD, eds. Disorders of Hemostasis Philadelphia: WB Saunders 1991: 459-479
    Google Scholar
  • 20 Rubin M H, Weston M J, Langley M H. Platelet function in chronic liver disease: relationship to disease severity.  Dig Dis Sci . 1979;  24 197-202
    CrossrefPubMedGoogle Scholar
  • 21 Ingeberg S, Jacobsen P, Fischer E. Platelet aggregation release of ATP in patients with hepatic cirrhosis.  Scand J Gastroenterol . 1985;  20 285-288
    PubMedGoogle Scholar
  • 22 Pereira S P, Langley P G, Williams R. The management of abnormalities of hemostasis in acute liver failure.  Semin Liver Dis . 1996;  16 403-414
    PubMedGoogle Scholar
  • 23 O'Grady J G, Alexander G JM, Hayllat K M. Early indicators of prognosis in fulminant hepatic failure.  Gastroenterology . 1989;  97 439-445
    PubMedGoogle Scholar
  • 24 Bismuth H, Samuel D, Castaing D. Orthotopic liver transplantation and subfulminant hepatitis. The Paul Brousse experience.  Ann Surg . 1995;  222 109-119
    PubMedGoogle Scholar
  • 25 Green G, Poller L, Thomsen J M. Factor VII as a marker of hepatocellular synthetic function in liver disease.  J Clin Pathol . 1976;  29 971-97
    CrossrefPubMedGoogle Scholar
  • 26 Paramo J A, Rocha E. Hemostasis in advanced liver disease.  Semin Thromb Hemost . 1993;  19 184-190
    PubMedGoogle Scholar
  • 27 Brophy M T, Fiore L D, Deykin D. Hemostasis. In: Zakim D, Boyer TD, eds. Hepatology, a Textbook of Liver Disease Philadelphia: WB Saunders 1996: 691-719
    Google Scholar
  • 28 Pugh R NH, Murray-Lyon I M, Dawson J L. Transection of the oesophagus for bleeding oesophageal varices.  Br J Surg . 1973;  60 646-649
    CrossrefPubMedGoogle Scholar
  • 29 Forman L M, Lucey M R. Predicting the prognosis of chronic liver disease: an evolution from child to MELD. Mayo end-stage liver disease.  Hepatology . 2001;  33 473-475
    CrossrefPubMedGoogle Scholar
  • 30 Rovert A, Chazouilleres O. Prothrombin time in liver failure: time, ratio, activity percentage, or international normalized ratio?.  Hepatology . 1996;  24 1392-1394
    CrossrefPubMedGoogle Scholar
  • 31 Dymock I W, Tucker J S, Woolf I L. Coagulation studies as a prognostic index in acute liver failure.  Br J Haematol . 1975;  29 385-395
    PubMedGoogle Scholar
  • 32 Cederblad G, Korsan-Bengsten K, Olsson R. Observation of increased levels of blood coagulation factors and other plasmaproteins in cholestatic liver disease.  Scand J Gastroenterol . 1976;  11 391-396
    PubMedGoogle Scholar
  • 33 Ben-Ari Z, Panagou M, Patch D. Hypercoagulability in patients with primary biliary cirrhosis and primary sclerosing cholangitis evaluated by thromboelastography.  J Hepatol . 1997;  26 554-559
    CrossrefPubMedGoogle Scholar
  • 34 Dumontier I, Alhenc-Gelas M, Chatellier G. Modifications des taux des inhibiteurs plasmatiques de la coagulation au cours de la cirrhose.  Gastroenterol Clin Biol . 1992;  16 120-125
    PubMedGoogle Scholar
  • 35 Denninger M H. Maladies du foie et hemostase.  Path Biol . 1999;  47 1006-1015.
    PubMedGoogle Scholar
  • 36 Sherlock S. Nutritional complications of biliary cirrhosis. Chronic colestasis.  Am J Clin Nutr . 1970;  23 640-644
    PubMedGoogle Scholar
  • 37 Gross L, Brotman M. Hypoprothrombinemia and hemorrhage associated with cholestyramine therapy.  Ann Intern Med . 1970;  72 95-96
    PubMedGoogle Scholar
  • 38 Andrassy K, Bechtold H, Ritz E. Hypoprothrombinemia caused by cephalosporins.  J Antimicrob Chemother . 1985;  15 133-136
    PubMedGoogle Scholar
  • 39 Iber F L, Shamszad M, Miller P A. Vitamin K deficiency in chronic alcoholic males.  Alcohol Clin Exp Res . 1986;  10 679-681
    PubMedGoogle Scholar
  • 40 Blanchard R A, Furie B C, Jorgensen M. Acquired vitamin K dependent carboxylation deficiency in liver disease.  N Engl J Med . 1981;  305 242-248
    PubMedGoogle Scholar
  • 41 Weitz I C, Liebman H A. Des-(-carboxy (abnormal) prothrombin and hepatocellular carcinoma: a critical review.  Hepatology . 1993;  18 990-997
    PubMedGoogle Scholar
  • 42 Liebman H A, Furie B, Tong M. Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma.  N Engl J Med . 1984;  310 1427-1431
    CrossrefPubMedGoogle Scholar
  • 43 Nakao A, Virji A, Karr B. Abnormal prothrombin (des-γ-carboxy prothrombin) in hepatocellular carcinoma.  Hepatogastroenterology . 1991;  38 450-453
    PubMedGoogle Scholar
  • 44 Drin F G, Thomson J M, Dymock I W. Abnormal fibrin polymerisation in liver disease.  Br J Haematol . 1976;  34 427-437
    PubMedGoogle Scholar
  • 45 Barr R D. Dysfibrinogenemia and liver cell growth.  J Clin Pathol . 1978;  31 89-92
    PubMedGoogle Scholar
  • 46 Violi F, Ferro D, Basili S. Hyperfibrinolysis resulting from clotting activation in patients with different degree of cirrhosis.  Hepatology . 1993;  17 78-83
    CrossrefPubMedGoogle Scholar
  • 47 Van Thiel H D, George M, Fareed J. Low levels of thrombin activatable fibrinolysis inhibitor (TAFI) in patients with chronic liver disease.  Thromb Haemost . 2001;  85 667-670
    PubMedGoogle Scholar
  • 48 Car J M. Disseminated intravascular coagulation in cirrhosis.  Hepatology . 1989;  10 103-110
    PubMedGoogle Scholar
  • 49 Hersch S L, Kunelis T, Francis R B. The pathogenesis of accelerated fibrinolysis in liver cirrhosis: a critical role for plasminogen activator inhibitor.  Blood . 1987;  69 1315-1319
    PubMedGoogle Scholar
  • 50 Hu K Q, Yu A S, Tiyygura L. Hyperfibrinolytic activity in hospitalized cirrhotic patients in a referral liver unit.  Am J Gastroenterol . 2001;  96 1581-1586
    CrossrefPubMedGoogle Scholar
  • 51 Agarwal S, Joyner K A, Swaim M W. Ascites as a possible origin for hyperfibrinolysis in advanced liver disease.  Am J Gastroenterol . 2000;  95 3218-3224
    CrossrefPubMedGoogle Scholar
  • 52 Patrassi G M, Martinelli S, Sturniolo G C. Fibrinolytic study in plasma and ascitic fluid of cirrhotic patients before and after ascites concentration reinfusion technique.  Eur J Clin Invest . 1985;  15 161-165
    PubMedGoogle Scholar
  • 53 Francis R B, Feinstein D I. Clinical significance of accelerated fibrinolysis in liver disease.  Haemostasis . 1984;  14 460-465
    PubMedGoogle Scholar
  • 54 Violi F, Alessandro C, Ferro D. Interrelation between factor VII, prekallikrein and hyperfibrinolysis in advanced cirrhosis.  J Clin Pathol . 1989;  42 1246-1249
    PubMedGoogle Scholar
  • 55 Violi F, Basili S, Ferro D. Association between high values of D-dimer and tissue-plasminogen activator activity and first gastrointestinal bleeding in cirrhotic patients.  Thromb Hemost . 1996;  76 177-183
    PubMedGoogle Scholar
  • 56 Levi M, Ten Cate H. Disseminated intravascular coagulation.  N Engl J Med . 1999;  341 586-592
    CrossrefPubMedGoogle Scholar
  • 57 Okajima K, Sakamoto Y, Uchiba M. Heterogeneity in the incidence and clinical manifestations of disseminated intravascular coagulation: a study of 204 cases.  Am J Hematol . 2000;  65 215-222
    CrossrefPubMedGoogle Scholar
  • 58 Violi F, Ferro D, Basili S. Association between low-grade disseminated intravascular coagulation and endotoxemia in patients with liver cirrhosis.  Gastroenterology . 1995;  109 531-539
    CrossrefPubMedGoogle Scholar
  • 59 Kemkes-Matthes B, Bleyl H, Matthes K J. Coagulation activation in liver diseases.  Thromb Res . 1991;  64 253-261
    CrossrefPubMedGoogle Scholar
  • 60 Joist J H. AICF and DIC in liver cirrhosis: Expressions of a hypercoagulable state.  Am J Gastroenterol . 1999;  94 2801-2803
    PubMedGoogle Scholar
  • 61 Ben-Ari Z, Osman E, Hutton R A. Disseminated intravascular coagulation in liver cirrhosis: fact or fiction?.  Am J Gastroenterol . 1999;  94 2977-2982
    CrossrefPubMedGoogle Scholar
  • 62 Cordova C, Musa A, Violi F. Improvement of some coagulation factors in cirrhotic patients treated with low dose of heparin.  Scand J Hematol . 1982;  29 235-240
    PubMedGoogle Scholar
  • 63 Patel T. Surgery in the patient with liver disease.  Mayo Clin Proc . 1999;  74 593-599
    CrossrefPubMedGoogle Scholar
  • 64 Friedman L S. The risk of surgery in patients with liver disease.  Hepatology . 1999;  29 1617-1623
    CrossrefPubMedGoogle Scholar
  • 65 Aranha G V. Cholecystectomy in cirrhotic patients: a formidable operation.  Am J Surg . 1982;  143 55-60
    CrossrefPubMedGoogle Scholar
  • 66 Garrison R N. Clarification of risk factor for abdominal operations in patients with hepatic cirrhosis.  Ann Surg . 1984;  199 648-655
    CrossrefPubMedGoogle Scholar
  • 67 Tsuji K, Eguchi Y, Kodama M. Postoperative hypercoagulable state followed by hyperfibrinolysis is related to wound healing after hepatic resection.  J Am Coll Surg . 1996;  183 230-238
    PubMedGoogle Scholar
  • 68 Meijer C, Wiezer M J, Hack C E. Coagulopathy following major liver resection: the effect of rBPI21 and the role of decreased synthesis of regulating proteins by the liver.  Shock . 2001;  15 261-271
    CrossrefPubMedGoogle Scholar
  • 69 McGill D B, Rakela J, Zinsmeister A R. A 21-year experience with major haemorrhage after percutaneous liver biopsy.  Gastroenterology . 1990;  99 1396-1400
    PubMedGoogle Scholar
  • 70 Forssell P L, Bronkowsky H L, Anderson P B. Intrahepatic haematoma after aspiration liver biopsy: a prospective randomised controlled trial using two different needles.  Dig Dis Sci . 1981;  26 631-635
    CrossrefPubMedGoogle Scholar
  • 71 Piccinino F, Sagnelli E, Pasquale G. Complications following percutaneous liver biopsy.  J Hepatol . 1986;  2 165-173
    CrossrefPubMedGoogle Scholar
  • 72 Ewe K. Bleeding after liver biopsy does not correlate with indices of peripheral coagulation.  Dig Dis Sci . 1981;  26 388-393
    CrossrefPubMedGoogle Scholar
  • 73 Dillon J F, Simpson K J, Hayes P C. Liver biopsy bleeding time-an unpredictable event.  J Gastroenterol Hepatol . 1994;  9 269-271
    CrossrefPubMedGoogle Scholar
  • 74 Gilmore I T, Burroughs A, Murray-Lyon I M. 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;  36 437-441
    CrossrefPubMedGoogle Scholar
  • 75 Bonnard P, Vitte R-L, Barbare J C. Is bleeding time measurement useful for choosing the liver biopsy route?.  <~>The results of a pragmatic, prospective multicentric study in 219 patients. J Clin Gastroenterol . 1999;  29 347-349
    PubMedGoogle Scholar
  • 76 Boberg K M, Brosstad F, Egeland T. Is a prolonged bleeding time associated with an increased risk of hemorrhage after liver biopsy?.  Thromb Haemost . 1999;  81 378-381
    PubMedGoogle Scholar
  • 77 Grant A, Neuberger J. Guidelines on the use of liver biopsy in clinical practice.  Gut . 1999;  45 (suppl IV) 1-11
    PubMedGoogle Scholar
  • 78 Papatheodoridis G V, Patch D, Watkinson A. Transjugular liver biopsy in the 1990s: a 2-year audit.  Aliment Pharmacol Ther . 1999;  13 603-608
    CrossrefPubMedGoogle Scholar
  • 79 Ozier Y, Steib A, Ickx B. Haemostatic disorders during liver transplantation.  Eur J Anaesthesiol . 2001;  18 208-218
    CrossrefPubMedGoogle Scholar
  • 80 Haagsma E B, Gips C H, Wesenhagen H. Liver disease and its effect on haemostasis during liver transplantation.  Liver . 1985;  5 123-128
    PubMedGoogle Scholar
  • 81 Bechstein W O, Neuhaus P. Bleeding problems in liver surgery and liver transplantation.  Chirurgie . 2000;  71 363-368
    PubMedGoogle Scholar
  • 82 Bontempo F A, Lewis J H, Van Thiel H D. The relation of preoperative coagulation findings to diagnosis, blood usage, and survival in adult liver transplantation.  Transplantation . 1985;  39 532-536
    CrossrefPubMedGoogle Scholar
  • 83 Segal H, Cottam S, Potter D. Coagulation and fibrinolysis in primary biliary cirrhosis compared with other liver disease and during orthotopic liver transplantation.  Hepatology . 1997;  25 683-688
    CrossrefPubMedGoogle Scholar
  • 84 Dzik W H, Arkin C F, Jenkins R L. Fibrinolysis during liver transplantation in humans: role of tissue-type plasminogen activator.  Blood . 1988;  71 1090-1096
    PubMedGoogle Scholar
  • 85 Kang Y, Lewis J H, Navalgund A. Epsilon-aminocaproic for treatment of fibrinolysis during liver transplantation.  Anesthesiology . 1987;  66 766-773
    PubMedGoogle Scholar
  • 86 Porte R J, Bontempo F A, Knot E A. Systemic effects of tissue plasminogen activator-associated fibrinolysis and its relation to thrombin generation in orthotopic liver transplantation.  Transplantation . 1989;  47 978-984
    CrossrefPubMedGoogle Scholar
  • 87 Porte R J, Molenaar I Q, Begliomini B. Aprotinin and transfusion requirements in orthotopic liver transplantation: a multicentre randomized double-blind study. EMSALT Study Group.  Lancet . 2000;  355 1303-1309
    CrossrefPubMedGoogle Scholar
  • 88 Marcel R J, Stegall W C, Suit C T. Continuous small-dose aprotinin controls fibrinolysis during orthotopic liver transplantation.  Anesth Analg . 1996;  82 1122-1125
    PubMedGoogle Scholar
  • 89 Dalmau A, Sabate A, Acosta F. Tranexamic acid reduces red cell transfusion better than epsilon-aminocaproic acid or placebo in liver transplantation.  Anesth Analg . 2000;  91 29-34
    PubMedGoogle Scholar
  • 90 Riess H, Jochum M, Machleidt W. Possible role of extracellularly released phagocyte proteinase coagulation disorder during liver transplantation.  Transplantation . 1991;  52 482-484
    PubMedGoogle Scholar
  • 91 Kettner S C, Gonano C, Seebach F. Endogenous heparin-like substances significantly impair coagulation in patients undergoing orthotopic liver transplantation.  Anesth Analg . 1998;  86 691-695.
    PubMedGoogle Scholar
  • 92 Porte R J, Blauw E, Knot E A. Role of the donor liver in the origin of platelet disorders and hyperfibrinolysis in liver transplantation.  J Hepatol . 1994;  21 592-600
    CrossrefPubMedGoogle Scholar
  • 93 Gillies B S. Thromboelastography and liver transplantation.  Semin Thromb Hemost . 1995;  21 (suppl 4) 45
    PubMedGoogle Scholar
  • 94 Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy.  Am J Obstet Gynecol . 1982;  142 159-167
    PubMedGoogle Scholar
  • 95 Sherlock S, Dooley J. Diseases of the Liver and Biliary System, 10th ed. Oxford, UK: Blackwell Science; . 1987: 475-483
    Google Scholar
  • 96 Sheikh R A, Yasmeen S, Pauly M P. Spontaneous intrahepatic hemorrhage and hepatic rupture in the HELLP syndrome: four cases and a review.  J Clin Gastroenterol . 1999;  28 323-328
    CrossrefPubMedGoogle Scholar
  • 97 Audibert F, Coffineau A, Edouard D. Prise en charge du HELLP syndrome avant 32 semaines d'amenorrhee.  Presse Med . 1996;  25 235-239
    PubMedGoogle Scholar
  • 98 Kobayashi T, Tokunaga N, Sugimura M. Predictive values of coagulation/fibrinolysis parameters for the determination of pregnancy complicated by severe preeclampsia.  Semin Thromb Hemost . 2001;  27 137-141
    Article in Thieme ConnectPubMedGoogle Scholar
  • 99 Kox T A, Olans L B. Liver disease in pregnancy.  N Engl J Med . 1996;  335 569-576
    CrossrefPubMedGoogle Scholar
  • 100 Pereira S P, O'Donohue J, Wendon J. Maternal and perinatal outcome in severe pregnancy-related liver disease.  Hepatology . 1997;  26 1258-1262
    PubMedGoogle Scholar
  • 101 Sherlock S. Acute fatty liver of pregnancy. In: Reyes HB, Leuschner U, Arias IM, eds. Pregnancy, sex hormones and liver Dordrecht, The Netherlands: Kluwer Academic, 1996: 202-208
    Google Scholar
  • 102 Castro M A, Fassett M J, Reynolds T B. Reversible peripartum liver failure: a new perspective on the diagnosis, treatment, and cause of acute fatty liver of pregnancy, based on 28 consecutive cases.  Am J Gynecol . 1999;  181 389-395
    CrossrefPubMedGoogle Scholar
  • 103 Castro M A, Goodwin T M, Shaw K J. Disseminated intravascular coagulation and antithrombin III depression in acute fatty liver of pregnancy.  Am J Obstet Gynecol . 1996;  174 211-216
    PubMedGoogle Scholar
  • 104 Bernard B, Grange J D, Khac E N. Antibiotic prophylaxis for the prevention of bacterial infections in cirrhotic patients with gastrointestinal bleeding: a meta-analysis.  Hepatology . 1999;  29 1655-1661
    CrossrefPubMedGoogle Scholar
  • 105 Goulis J, Armonis A, Patch D. Bacterial infection is independently associated with failure to control bleeding in cirrhotic patients with gastrointestinal hemorrhage.  Hepatology . 1998;  27 1207-1212
    CrossrefPubMedGoogle Scholar
  • 106 Bernard B, Cadranel J F, Valla D. Prognostic significance of bacterial infection in bleeding cirrhotic patients: a prospective study.  Gastroenterology . 1995;  108 1828-1834
    PubMedGoogle Scholar
  • 107 Goulis J, Patch D, Burroughs A K. Bacterial infection in the pathogenesis of variceal bleeding.  Lancet . 1999;  353 139-142
    CrossrefPubMedGoogle Scholar
  • 108 Papatheodoridis G V, Patch D, Webster J M. Infection and hemostasis in decompensed cirrhosis: a prospective study using thromboelastography.  Hepatology . 1999;  29 1085-1090
    CrossrefPubMedGoogle Scholar
  • 109 Chau T N, Chan Y W, Patch D. Thromboelastographic changes and early rebleeding in cirrhotic patients with variceal bleeding.  Gut . 1998;  43 267-271
    CrossrefPubMedGoogle Scholar
  • 110 Oka K, Tanaka K. Local fibrinolysis of esophagus and stomach as the cause of hemorrhage in liver cirrhosis.  Thrombosis Res . 1979;  14 837-844
    CrossrefPubMedGoogle Scholar
  • 111 Francis R J, Feinstein D I. Clinical significance of accelerated fibrinolysis in liver disease.  Haemostasis . 1984;  14 460-465
    PubMedGoogle Scholar
  • 112 Boks A L, Brommer E J, Schalm S W. Hemostasis and fibrinolysis in severe liver failure and their relation to hemorrhage.  Hepatology . 1986;  6 79-86
    CrossrefPubMedGoogle Scholar
  • 113 Piscaglia F, Siringo S, Hermida R C. Diurnal changes of fibrinolysis in patients with liver cirrhosis and esophageal varices.  Hepatology . 2000;  31 349-357
    CrossrefPubMedGoogle Scholar
  • 114 Grignani G, Maiolo A. Cytokines and hemostasis.  Haematologica . 2000;  85 967-972
    PubMedGoogle Scholar
  • 115 Basili S, Ferro D, Violi F. Endotoxaemia, hyperfibrinolysis and bleeding in cirrhosis.  Lancet . 1999;  353 1102
    PubMedGoogle Scholar
  • 116 Saliola M, Lorenzet R, Ferro D. Enhanced expression of monocyte tissue factor in patients with liver cirrhosis.  Gut . 1998;  43 428-432
    CrossrefPubMedGoogle Scholar
  • 117 Ferro D, Basili S, Pratico D. Vitamin E reduces monocyte tissue factor expression in cirrhotic patients.  Blood . 1999;  93 2945-2950
    PubMedGoogle Scholar
  • 118 Yerdel M A, Gunson B, Mirza D. Portal vein thrombosis in adults undergoing liver transplantation: risk factors, screening, management, and outcome.  Transplantation . 2000;  69 1873-1881
    CrossrefPubMedGoogle Scholar
  • 119 Okuda K, Ohnishi K, Kimura K. Incidence of portal vein thrombosis in liver cirrhosis: an angiographic study of 708 patients.  Gastroenterology . 1985;  89 279-286
    PubMedGoogle Scholar
  • 120 Manzanet G, Sanjuan F, Orbis P. Liver transplantation in patients with portal vein thrombosis.  Liver Transplant . 2001;  7 125-131
    CrossrefPubMedGoogle Scholar
  • 121 Denninger M H, Chait Y, Casadevall N. Cause of portal and hepatic venous thrombosis in adults: the role of multiple concurrent factors.  Hepatology . 2000;  31 587-591
    CrossrefPubMedGoogle Scholar
  • 122 Valla D C, Condat B. Portal vein thrombosis in adults: pathophysiology, pathogenesis and management.  J Hepatol . 2000;  32 865-871
    CrossrefPubMedGoogle Scholar
  • 123 Amitrano L, Brancaccio V, Guardascione M A. Inherited coagulation disorders in cirrhotic patients with portal vein thrombosis.  Hepatology . 2000;  31 345-348
    CrossrefPubMedGoogle Scholar
  • 124 Romero Gomez M, Garcia E S, Lacomba D L. Antiphospholipid antibodies are related to portal vein thrombosis in patients with liver cirrhosis.  J Clin Gastroenterol . 2000;  31 237-240
    CrossrefPubMedGoogle Scholar
  • 125 Dalekos G N, Kistis K G, Boumba D S. Increased incidence of anti-cardiolipin antibodies in patients with hepatitis C is not associated with aetiopathogenetic link to anti-phospholipid syndrome.  Eur J Gastroenterol Hepatol . 2000;  12 67-74
    PubMedGoogle Scholar
  • 126 Ordi-Ros J, Villarreal J, Monegal F. Anticardiolipin antibodies in patients with chronic hepatitis C virus infection: characterization in relation to antiphospholipid syndrome.  Clin Diagn Lab Immunol . 2000;  7 241-244
    CrossrefPubMedGoogle Scholar
  • 127 Mangia A, Margaglione M, Cascavilla I. Anticardiolipin antibodies in patients with liver disease.  Am J Gastroenterol . 1999;  94 2983-2987
    CrossrefPubMedGoogle Scholar
  • 128 Collier J D, Sale J, Friend P J. Graft loss and the antiphospholipid syndrome following liver transplantation.  J Hepatol . 1998;  29 999-1003
    CrossrefPubMedGoogle Scholar
  • 129 Everson G T. A hepatologist's perspective on the management of coagulation disorders before liver transplantation.  Liver Transplant Surg . 1997;  3 646-652
    PubMedGoogle Scholar
  • 130 Spector I, Corn M, Ticktin H E. Effect of plasma transfusions on the prothrombin time and clotting factors in liver disease.  N Engl J Med . 1966;  275 1032-1037
    PubMedGoogle Scholar
  • 131 Holland P V. Post-transfusion hepatitis: current risks and causes.  Vox Sang . 1998;  74(Suppl 2) 135-141
    PubMedGoogle Scholar
  • 132 Williamson L M, Llewelyn C A, Fisher N C. A randomized trial of solvent/detergent-treated and standard fresh-frozen plasma in the coagulopathy of liver disease and liver transplantation.  Transfusion . 1999;  39 1227-1234
    CrossrefPubMedGoogle Scholar
  • 133 Practice guidelines for blood component therapy. Anesthesiology .  1996;  84 732-747
    PubMedGoogle Scholar
  • 134 Seitz R, Dodt J. Virus safety of prothrombin complex concentrates and factor IX concentrates.  Thromb Res . 1999;  95(Suppl) 19-23
    CrossrefPubMedGoogle Scholar
  • 135 Kohler M. Thrombogenicity of prothrombin complex concentrates.  Thromb Res . 1999;  95(Suppl 1) 13-17
    CrossrefPubMedGoogle Scholar
  • 136 Hellstern P, Halbmayer W M, Kohler M. Prothrombin complex concentrates: indications, contraindications, and risks: a task force summary.  Thromb Res . 1999;  95(Suppl) 3-6
    PubMedGoogle Scholar
  • 137 Hedner U. Novoseven as a universal haemostatic agent.  Blood Coagul Fibrinolysis . 2000;  11 (suppl 1) 107-111
    PubMedGoogle Scholar
  • 138 Bernstein D. Effectiveness of the recombinant factor VIIa in patients with the coagulopathy of advanced child's B and C cirrhosis.  Semin Thromb Hemost . 2000;  26 437-438
    Article in Thieme ConnectPubMedGoogle Scholar
  • 139 Chaunsumrit A, Chantarojanasiri T, Isarangkura P. Recombinant activated factor VII in children with acute bleeding resulting from liver failure and disseminated intravascular coagulation.  Blood Coagul Fibrinolysis . 2000;  11(Suppl 1) 101-105
    PubMedGoogle Scholar
  • 140 Hendriks H G, Meijer K, de Wolf T J. Reduced transfusion requirements by recombinant factor VIIa in orthotopic liver transplantation: a pilot study.  Transplantation . 2001;  71 402-405
    CrossrefPubMedGoogle Scholar
  • 141 Murphy M F. State of the art in platelet transfusion therapy.  Transfus Sci . 1996;  17 575-584
    PubMedGoogle Scholar
  • 142 Weber T, Marino I R, Kang Y G. Intraoperative blood transfusions in highly alloimmunized patients undergoing orthotopic liver transplantation.  Transplantation . 1989;  47 797-801
    PubMedGoogle Scholar
  • 143 Kaul V V, Munoz S J. Coagulopathy of liver disease.  Curr Treat Options Gastroenterol . 2000;  3 433-438
    CrossrefPubMedGoogle Scholar
  • 144 Carr J M. Hemostatic disorders in liver disease. In: Schiff L, Schiff ER, eds. Diseases of the Liver Philadelphia: JB Lippincott 1993: 1061-1076
    Google Scholar
  • 145 Green B, Cairns S, Harvey R. Phytomenadione or menadiol in the management of an elevated international normalized ratio (prothrombin time).  Aliment Pharmacol Ther . 2000;  14 1685-1689
    CrossrefPubMedGoogle Scholar
  • 146 Burroughs A K, Matthews K, Qadiri M. Desmopressin and bleeding time in patients with cirrhosis: Br J Med .  1985;  291 1377-1381
    PubMedGoogle Scholar
  • 147 Mannucci P M, Vicente V, Vianello L. Controlled trial of desmopressin (DDAVP) in liver cirrhosis and other conditions associated with a prolonged bleeding time.  Blood . 1986;  67 1148-1153
    PubMedGoogle Scholar
  • 148 Mannucci P M. Desmopressin (DDAVP) in the treatment of bleeding disorders: the first 20 years.  Blood . 1997;  90 2515-2521
    PubMedGoogle Scholar
  • 149 de Franchis R, Arcidiacono P G, Carpinelli P G. Randomized controlled trial of desmopressin plus terlipressin and terlipressin alone for the treatment of acute variceal hemorrhage in cirrhotic patients: a multicenter, double blind study.  Hepatology . 1993;  18 1102-1107
    CrossrefPubMedGoogle Scholar
      >