ReviewInternational journal of laboratory hematology2022
Pathophysiology and management of bleeding and thrombosis in patients with liver disease.
Review in International journal of laboratory hematology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 22 citations in OpenAlex.
- Rotational thromboelastometry versus conventional tests in decompensated cirrhotic children undergoing invasive procedures.Journal of pediatric gastroenterology and nutrition · 2026Trial
- [Acute management of bleeding complications and coagulation disorders in critically ill patients with liver cirrhosis].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- [Pathophysiological mechanisms of coagulation dysfunction associated with liver disease].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Thrombin Generation in Acute and Chronic Liver Disease in Children.Diagnostics (Basel, Switzerland) · 2026Article
- Optimizing sedation in elderly patients: advantages and challenges of alfentanil-ciprofol for painless gastroscopy.American journal of translational research · 2026Review
- Clinical and pathophysiological perspectives on haemostasis, inflammation, and thrombo-haemorrhagic risk in cirrhosis.EXCLI journal · 2026Review
- Article
- Acute Subdural Hematoma Without Subarachnoid Hemorrhage Due to Traumatic Aneurysm of the Posterior Cerebral Artery.Cureus · 2025Article
- Hematological Markers in Thromboembolic Events: A Comparative Study of COVID-19 and Non-COVID-19 Hospitalized Patients.Journal of clinical medicine · 2025Article
- Cirrhosis Progression Is Not Associated with Clinically Significant Alterations in Global Hemostasis Assessed by Thromboelastography.Journal of clinical medicine · 2024Article
- Direct oral anticoagulants in cirrhosis: Rationale and current evidence.JHEP reports : innovation in hepatology · 2024Review
- Treatment of portal vein thrombosis in cirrhosis with anticoagulation-more than meets the eye?Hepatobiliary surgery and nutrition · 2024Article
- Contemporary management of major haemorrhage in critical care.Intensive care medicine · 2024Review
- How to assess hemostasis in patients with severe liver disease.Hematology. American Society of Hematology. Education Program · 2023Article
- Pathophysiology and management of bleeding and thrombosis in patients with liver disease.International journal of laboratory hematology · 2022Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients with liver disease often develop complex changes in their haemostatic system. Frequently observed changes include thrombocytopaenia and altered plasma levels of most of the proteins involved in haemostasis. Although liver disease was historically classified as a haemostasis-related bleeding disorder, it has now been well established that the antihaemostatic changes that promote bleeding are compensated for by prohaemostatic changes. Conventional coagulation tests however do not accurately reflect these prohaemostatic changes, resulting in an underestimation of haemostatic potential. Novel coagulation tests, such as viscoelastic tests (VETs) and thrombin generation assays (TGAs) better reflect the net result of the haemostatic changes in patients with liver disease, and demonstrate a new, "rebalanced" haemostatic status. Although rebalanced, this haemostatic status is more fragile than in patients without liver disease. Patients with liver disease are therefore not only at risk of bleeding but also at risk of thrombosis. Notably, however, many haemostatic complications in liver disease are not related to the haemostatic failure. It is, therefore, crucial to identify the cause of the bleed or thrombotic complication in order to provide adequate treatment. In this paper, we will elaborate on the haemostatic changes that occur in liver disease, reflect on laboratory and clinical studies over the last few years, and explore the pathophysiologies of bleeding and thrombosis in this specific patient group.
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