title: [Coagulation and cirrhosis: new insight].
abstract: The liver plays a key role in coagulation as all clotting factors except for factor VIII are synthetized by hepatocytes. In cirrhotic patients, there is a decrease of clotting factors and a thrombocytopenia. Those parameters usually modify routine coagulation tests and may suggest that cirrhotic patients are at a higher risk of bleeding. However, studies have shown that these patients are rather at risk for thrombosis. The reason is a concomitant decrease of coagulation inhibitors factors that is not detected in routine laboratory coagulation tests. The coagulation system in cirrhotic patient is a balance of pro and anti-coagulants. This balance may be affected by co-factors such as renal failure or infection. Artificial correction of laboratory values by transfusion of blood products may be rather deleterious (e.g. volume overload, TRALI).
authors.affiliation: Service de gastroentérologie et hépatologie, Département des spécialités de médecine, HUG, Genève. saskia.i.ditisheim@hcuge.ch
authors.forename: S
authors.initials: S
authors.lastname: Ditisheim
authors.forename: N
authors.initials: N
authors.lastname: Goossens
authors.forename: L
authors.initials: L
authors.lastname: Spahr
authors.forename: A
authors.initials: A
authors.lastname: Hadengue
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001777:Blood Coagulation; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000517:prevention & control; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D008099:Liver / Q000502:physiology; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control
chemical_list: D000925:Anticoagulants