Coagulopathy of acute liver failure.
Coagulopathy is an essential component of the acute liver failure (ALF) syndrome and reflects the central role of liver function in hemostasis. ALF is a syndrome characterized by the development of hepatic encephalopathy and coagulopathy within 24 weeks of the onset of acute liver disease. Coagulopathy in this setting is a useful prognostic tool in ALF and a dynamic indicator of the hepatic function. If severe, it can be associated with bleeding and is commonly a major obstacle to the performance of invasive procedures in patients with ALF. This review focuses on the epidemiology, pathophysiology, presentation, evaluation, and management of coagulopathy in ALF.
Munoz
Santiago J
SJ
University of Pennsylvania, School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA; PENN Presbyterian Medical Center, 38th and Market Streets, MOB 220, Philadelphia, PA 19104, USA. Electronic address: Santiago.Munoz@uphs.upenn.edu.
Stravitz
R Todd
RT
Section of Hepatology, Hume-Lee Transplant Center, PO Box 980341, Virginia Commonwealth University, Richmond, VA 23298-0341, USA.
Gabriel
Don A
DA
Division of Hematology/Oncology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, NC 27599, USA.
D001778:Blood Coagulation Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D018450:Disease Progression; D006470:Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D019934:International Normalized Ratio; D017114:Liver Failure, Acute / Q000097:blood* / Q000150:complications; D016031:Liver Transplantation; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy