High molecular weight kininogens [HMWK] and coagulation factor VII as prognostic landmarks in the prediction of hepatic decompensation

ABSTRACT

Owing to their delicate nature coagulation proteins could be strongly considered as sensitive parameters in assessment of the hepatic functions, Vierling [1984]. Plasma coagulation factors are very sensitive to liver failure yielding a good indication of terminal liver protein insufficiency. Many investigators studied various coagulation parameters aiming at evaluation of their prognostic value in chronic liver diseases. They reported that no single parameter is by itself a definitive indication for a terminal hepatopathy, Biland et al. [1978]. This problem is still controversial. Vierling [1984] suggested that a prothrombin time eight seconds longer than control values represent an adverse prognostic index hepatic insufficiency. In fact prothrombin time assay does not seem to differentiate between survivors and non survivors when cirrhotic cases were followed. Therefore, a great deal of attention has been given to identify blood coagulation factors that are more sensitive to liver failure to evaluate their prognostic importance. Initial studies suggested that factor VII. a protein of prothrombin complex with a short half life, and HMWK are sensitive indexes of liver damage. Orlando et al [1982] and Cordova et al [1984]. Therefore, the objective of the present study is to further investigate this clinical problem. Therefore, coagulation factor VII and HMWK have been assayed simultaneously in liver cirrhosis and chronic hepatitis in compensated as well as decompensated stages