title: Abnormalities of hemostasis and bleeding in chronic liver disease: the paradigm is challenged.
abstract: Chronic liver disease is characterized by a global hemostatic defect including platelet-vessel wall interaction (primary hemostasis), coagulation and fibrinolysis that may cause abnormalities of the relevant laboratory tests. The causal relationship between abnormal tests and bleeding has been widely accepted, despite the fact that abnormal tests are poorly associated with the timing and incidence of actual bleeding. In this article, we review recent evidence from the literature that disputes the above paradigm, and opens new venues for laboratory/clinical research and patient management in this field.
authors.affiliation: Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, University Medical School and IRCCS Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena Foundation, Milan, Italy. armando.tripodi@unimi.it
authors.forename: Armando
authors.initials: A
authors.lastname: Tripodi
authors.forename: Massimo
authors.initials: M
authors.lastname: Primignani
authors.forename: Pier Mannuccio
authors.initials: PM
authors.lastname: Mannucci
mesh_terms: D006470:Hemorrhage / Q000209:etiology / Q000503:physiopathology*; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications