Trastornos de coagulación en el cirrótico / Coagulation disorders in cirrhosis

The liver plays a central role in the clotting process. In this organ are sintetizated the major part of the coagulation factors. Historically, was considered that alteration in liver function causes important bleeding disorders. However, actual evidence is not in agreement with this asseveration. Decreased synthesis of clotting and inhibitor factors, decrease clearance of activated factors, quantitative and qualitative platelet defects, hyperfibrinolysis and intravascular coagulation are some of the defects observed in liver diseases. Thrombotic events, even if rare in cirrhotic patients, occur manly in the portal and mesenteric veins. The aim of the present work is to review the present evidence in coagulation disorders and liver disease.

El hígado participa de manera importante en el proceso de la coagulación. En él se sintetizan la mayor parte de los factores pro- y anticoagulantes. De manera histórica se ha considerado que las alteraciones en la función de este órgano provoca trastornos predisponentes para eventos de sangrado. La evidencia actual pone en tela de juicio esta aseveración. En los casos de hepatopatía se hacen evidentes alteraciones en el número y funcionamiento de las plaquetas, disminución de la síntesis de factores de la coagulación, disfibrinogenemia, alteraciones en la fibrinólisis, deficiencia de vitamina K y cambios similares a los ocurridos en la coagulación intravascular diseminada (CID). El presente trabajo está dirigido a revisar los conocimientos actuales respecto a las alteraciones de la coagulación presentes en los pacientes con hepatopatías.

study on the application efficacy of solvent-detergent [S/D] treatment in the process of purifying factor VII from prothrombin complex

The risks of transmitting viral infection by blood and plasma-derived products have long been known and still remain an area of concern. In this study, in the process of purifying human factor VII from prothrombin complex, S/D treatment using tri-n-butyl phosphate and Tween 80 was employed and its capability and efficacy was studied. The results indicated that the process did not affect the biological function of the essential coagulation factors studied. In addition, the process was shown to be effective on enveloped viruses, where its inactivation factor for the model used, Herpes Simplex type I, was 5.5 logs. However, the procedure was not effective on poliovirus which was used as a model for non-enveloped viruses. It is therefore concluded that for increasing viral safety it is best to apply at least one more inactivating procedure which will be effective on non-enveloped viruses as well