Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Monday, 01 / 25 / 2021

Articles

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Clinical Considerations of Coagulopathy in Acute Liver Failure

Ahyoung Kim1, Bolin Niu2Tinsay Woreta1 and Po-Hung Chen*,1

1  Division of Gastroenterology & Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
2  Division of Gastroenterology & Hepatology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
*Correspondence to: Po-Hung Chen, Division of Gastroenterology & Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Suite 429, Baltimore, MD 21287, USA. Tel: +1-410-614-3530, Fax: +1-410-550-7861, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2020;8(4):407-413 DOI: 10.14218/JCTH.2020.00058
Received: June 20, 2020 Accepted: August 31, 2020 Published online: October 10, 2020

Abstract

Acute liver failure (ALF) is the rapid onset of severe liver dysfunction, defined by the presence of hepatic encephalopathy and impaired synthetic function (international normalized ratio of ≥1.5) in the absence of underlying liver disease. The elevated international normalized ratio value in ALF is often misinterpreted as an increased hemorrhagic tendency, which can lead to inappropriate, prophylactic transfusions of blood products. However, global assessments of coagulopathy via viscoelastic tests or thrombin generation assay suggest a reestablished hemostatic, or even hypercoagulable, status in patients with ALF. Although the current versions of global assays are not perfect, they can provide more nuanced insights into the hemostatic system in ALF than the conventional measures of coagulopathy.

Keywords

Acute liver failure, Coagulopathy, Thrombin generation assay, Viscoelastic test

Journal of Clinical and Translational Hepatology 2020 vol. 8, 407-413  [ Html  ] [ PDF Full-text ]

© The Authors 2020. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.

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