Scripties UMCG - Rijksuniversiteit Groningen
 
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Functional and Structural Abnormalities of the Fibrin Clot in acutely ill Patients with Liver Disease

(2018) Chao, X.L. (Xu Lu)

Very little is known on how to optimally prevent or treat bleeding or thrombosis in acutely ill
patients with liver disease, in part because the patients are paradoxically at risk for both
complications at the same time due to their complex hemostatic balance. In recent years, it
has been determined that fibrin clots in patients with cirrhosis are more prothrombotic
compared to healthy individuals, but this has not been studied in more acutely ill patients with
liver disease who have more severe complications. To investigate whether the prothrombotic
properties of the fibrin clot are maintained in acutely ill patients with liver disease, we
determined the clotting time and permeability of fibrin clots from patients with
decompensated cirrhosis, acute-on-chronic liver failure and acute liver failure and compared
them to healthy controls. The results showed a decreased permeability despite a delayed
clotting time with induced with tissue factor and thrombin in these patients. Prothrombotic
properties of the fibrin clot were demonstrated to increase with increasing severity of disease.
As prothrombotic properties of the fibrin clot are associated with an increased risk of
thrombotic disease, these findings likely have clinical relevance.






 
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