Saner, F.H.; Scarlatescu, E.; Broering, D.C.; Bezinover, D. The Yin and the Yang of Hemostasis in End-Stage Liver Disease. J. Clin. Med.2023, 12, 5759.
Saner, F.H.; Scarlatescu, E.; Broering, D.C.; Bezinover, D. The Yin and the Yang of Hemostasis in End-Stage Liver Disease. J. Clin. Med. 2023, 12, 5759.
Saner, F.H.; Scarlatescu, E.; Broering, D.C.; Bezinover, D. The Yin and the Yang of Hemostasis in End-Stage Liver Disease. J. Clin. Med.2023, 12, 5759.
Saner, F.H.; Scarlatescu, E.; Broering, D.C.; Bezinover, D. The Yin and the Yang of Hemostasis in End-Stage Liver Disease. J. Clin. Med. 2023, 12, 5759.
Abstract
Patients with end stage liver disease (ESLD) undergoing liver transplantation are prone to thromboses both while on the waiting list or in the perioperative period. This hypercoagulability is associated with significant endothelial dysfunction (ED) due to nitric oxide dysregulation. ED in combination with increased thrombin generation are the main factors responsible for this hypercoagulability. Sepsis itself can significantly change the coagulation profile, but in combination with ESLD, sepsis, and septic shock is responsible for very complex changes in the patients coagulation making both assessment and management of coagulation in patients with ESLD very challenging. Viscoelastic testing (VET) is a preferred method of coagulation management in patients with cirrhosis because, as with standard laboratory testing, VET can assess the entire coagulation system including the interaction between both pro- and anticoagulants and platelets.
Medicine and Pharmacology, Gastroenterology and Hepatology
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