Advances in basic and clinical manifestations of coagulopathy in end-stage liver diseases / 医学研究生学报

ABSTRACT

The liver plays a central role in hemostasis as the site of synthesis of most procoagulant and anticoagulant factors, and the clearance of many hemostatic and fibrinolytic components. On one hand, the decreased synthetic capacity of the liver due to end-stage liver diseases（ESLD） results in decreased hepatocyte-derived hemostatic proteins in plasma. On the other hand, intrahepatic and systemic inflammation in liver diseases results in chronic endothelial cell activation with additional consumption of platelets and hemostatic proteins. This two-way change makes the clotting state of end-stage liver disease extremely complicated and unpredictable. The common laboratory tests, such as prothrombin time (PT) and activated partial thromboplastin time (aPTT), cannot precisely reflect the change of hemostasis in vivo in ESLD. Thus, in-depth understanding this disorder with more comprehensive tests, can more effectively promote the progress of diagnosis and treatment of coagulopathy in ESLD. This article reviews the characteristics of changes in coagulation function, related detection methods, treatment and prevention in ESLD.