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- W4313490636 abstract "The liver plays an important role in coagulation pathways which is involved in primary and secondary tertiary haemostasis. It is the site of production for most of the coagulation factors except for von Willebrand factor (vWf) which is synthetised by the vascular endothelium. The liver also produces anticoagulant factors—Anti-thrombin III, Protein C and Protein S. Patients with advanced liver disease are associated with impairment of coagulation. Normally there is a balance between procoagulant and anticoagulant system which can be disturbed during progression of liver disease. As the liver disease advances multiple changes occur in the haemostatic system, thereby leading to reduced level of both procoagulative and anticoagulative factors—which were being synthetised by the hepatocytes and sinusoidal cells. In addition to this there could be deficiency of vitamin K which leads to abnormal clotting factor production as this vitamin (vitamin K) is required for gamma carboxylation. So the coagulation factors produced by the liver, which is already damaged, produce clotting factors which may be abnormal in nature. End-stage liver disease (ESLD) there is also reduced capacity to clear the activated clotting factors and their inhibitor complexes from the circulation. So the overall effect of the liver disease is quite complex and can lead to bleeding as well as thrombotic complications. As the disease progresses it leads to development of portal hypertension which results in splenomegaly and thrombocytopenia. Thrombocytopenia can further be accentuated due to decreased synthesis of thrombopoietin in the failing liver." @default.
- W4313490636 created "2023-01-06" @default.
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- W4313490636 date "2023-01-01" @default.
- W4313490636 modified "2023-09-27" @default.
- W4313490636 title "Coagulation in Liver Disease" @default.
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- W4313490636 doi "https://doi.org/10.1007/978-981-19-6045-1_13" @default.
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