title: Coagulopathy Before and After Liver Transplantation: From the Hepatic to the Systemic Circulatory Systems.
abstract: The hemostatic environment in patients with cirrhosis is a delicate balance between prohemostatic and antihemostatic factors. There is a lack of effective laboratory measures of the hemostatic system in patients with cirrhosis. Many are predisposed to pulmonary embolus, deep vein thrombosis, and portal vein thrombosis in the pretransplantation setting. This pretransplantation hypercoagulable milieu seems to extend for at least several months post-transplantation. Patients with nonalcoholic fatty liver disease, inherited thrombophilia, portal hypertension in the absence of cirrhosis, and hepatocellular carcinoma often require individualized approach to anticoagulation. Early reports suggest a potential role for low-molecular-weight heparins and direct-acting anticoagulants.
authors.affiliation: Center for the Study of Coagulation Disorders in Liver Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of Virginia, 1215 JPA and Lee Street, Charlottesville, VA 22908, USA.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Stine
authors.affiliation: Center for the Study of Coagulation Disorders in Liver Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of Virginia, 1215 JPA and Lee Street, Charlottesville, VA 22908, USA. Electronic address: northup@virginia.edu.
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Northup
mesh_terms: D001778:Blood Coagulation Disorders / Q000150:complications*; D058625:End Stage Liver Disease / Q000150:complications / Q000601:surgery*; D014943:Global Health; D006801:Humans; D016031:Liver Transplantation; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D057234:Preoperative Period
keywords: Coagulation; End-stage liver disease; Hemostasis; Hypercoagulable state; Thromboembolic disease