Interrelation between factor VII, prekallikrein, and hyperfibrinolysis in advanced cirrhosis.
Factor VII and prekallikrein activities were studied in 37 patients with liver cirrhosis who were in a decompensated state. Sixteen of them died 30-70 days after admission; 21 survived and were discharged after 30-80 days. Seven who died and six survivors had signs of hyperfibrinolysis: factor VII activity differentiated the two groups independently of the presence of hyperfibrinolysis. The presence of hyperfibrinolysis significantly reduced prekallikrein activity, which did not differentiate clearly survivors from non-survivors. Long term follow up of survivors showed a good correlation between factor VII and prekallikrein activities with long term survival. Hyperfibrinolysis seemed to influence the clinical course of patients: 87% of patients with hyperfibrinolysis who died had fatal haemorrhagic episodes. Low factor VII activity may be a precursor of terminal liver insufficiency.
Violi
F
F
Istituto di I Clinica Medica, University La Sapienza, Rome, Italy.
Alessandri
C
C
Ferro
D
D
Saliola
M
M
Cordova
C
C
Musca
A
A
Balsano
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D001778:Blood Coagulation Disorders / Q000150:complications; D005167:Factor VII / Q000378:metabolism*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011288:Prekallikrein / Q000378:metabolism*; D011379:Prognosis
D005167:Factor VII; D011288:Prekallikrein; D001663:Bilirubin