The Platelet and Platelet Function Testing in Liver Disease

Hugenholtz, Greg C. G.; Porte, Robert J.; Lisman, Ton

doi:10.1016/j.cld.2008.09.010

Cited by 54 publications

(33 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Platalet dysfunctions are generally related with the severity of liver disease. When plataletpoor plasmas of these patients are incubated with normal platalets, normal platalet functions can not be observed and this is thought to be related with presence of fibrin destruction products in the plasma of the patients with liver disease (21). In addition, large platalets which are active and known to be more efficient in hemostasis are found with a low number in patients with liver disease (21).…”

Section: Plateletes and Liver Diseasesmentioning

confidence: 99%

“…When plataletpoor plasmas of these patients are incubated with normal platalets, normal platalet functions can not be observed and this is thought to be related with presence of fibrin destruction products in the plasma of the patients with liver disease (21). In addition, large platalets which are active and known to be more efficient in hemostasis are found with a low number in patients with liver disease (21). The altered cholesterol/phospholipid ratio in patients with liver disease also disrupts platalet functions by inhibiting sufficient "prostoglandin" production in the arachidonic acid (AA) pathway (25,26).…”

Section: Plateletes and Liver Diseasesmentioning

confidence: 99%

“…Portal hypertension and related splenomegaly and reserving of the platalets in the spleen is the most important reason for Table 2 thrombocytopenia (21). In addition, DIC and decreased production also contribute to thrombocytopenia.…”

Section: Plateletes and Liver Diseasesmentioning

confidence: 99%

See 2 more Smart Citations

Karaciğer hastalıklarında pıhtılaşma-tromboz mekanizmasına neler oluyor?

Celkan¹

2013

Tpa

View full text Add to dashboard Cite

SummaryChildren with liver disease present complex and varied acquired coagulation abnormalities. Liver is the place where clotting factors are produced as well as inhibitors of coagulation and fibrinolytic system components. Although 75-85% of patients with liver disease show abnormal laboratory values, only 10-15% will have clinical bleeding symptoms, as liver has a large factor reserve capacity. This paper will review acute and chronic liver disease and the hemostatic alterations. Treatment of the coagulopaty of liver disease is usually replacement of lacking factor and supportive care. Liver transplantation, which is very common recently, and its affects on hematological balance will also summarized. (Turk Arch Ped 2013; 48: 94-101)

show abstract

Section: Plateletes and Liver Diseasesmentioning

confidence: 99%

Section: Plateletes and Liver Diseasesmentioning

confidence: 99%

See 1 more Smart Citation

Karaciğer hastalıklarında pıhtılaşma-tromboz mekanizmasına neler oluyor?

Celkan¹

2013

Tpa

View full text Add to dashboard Cite

show abstract

“…Platelet function defects are also seen, but are of unclear significance. 12,13 Elevated levels of markers of platelet activation, thrombin and fibrin generation, and fibrinolysis are present, but can be due to hyperfibrinolysis, low-grade disseminated intravascular coagulation, or decreased hepatic clearance. 12 Other conditions play a role in the bleeding tendency of patients with decompensated chronic liver disease, including hemodynamic alterations due to portal hypertension or endothelial dysfunction and the development of endogenous heparin-like substances due to bacterial infections and renal failure.…”

Section: Pathophysiology Of the Coagulopathy Of Liver Diseasementioning

confidence: 99%

Bleeding and Clotting Disorders in Pediatric Liver Disease

Wicklund

2011

Hematology

View full text Add to dashboard Cite

The coagulopathy of liver disease in pediatric patients presents an unusual set of challenges. Little pediatric data have been published, so this review is based largely on adult studies. There is a precarious balance between deficiencies of clotting factors and anticoagulation factors in liver disease that result in abnormal prothrombin time (PT) and activated partial thromboplastin time (aPTT) tests that would suggest a bleeding tendency, yet the patients can form a clot and are at risk of thromboembolic disease. Attention has centered on thromboelastography and thrombin-generation assays to clarify the patient's ability to control bleeding, but these tests are not routinely available to many treating physicians.

show abstract

“…44 Bleeding is also associated with thrombocytopenia secondary to hypersplenism, thrombopoietein deficiency, (myelosuppression due to hepatitis C, folate deficiency, and ethanol toxicity), autoantibodies and low-grade disseminated intravascular coagulation (DIC). 45 Conventional coagulation tests include clotting time, PT, INR, and activated partial thromboplastin time. These measure only part of the process of thrombin generation.…”

Section: Hemostasismentioning

confidence: 99%

Surgery in a Patient with Liver Disease

Rai

Nagral

2012

Journal of Clinical and Experimental Hepatology

View full text Add to dashboard Cite

Surgery is often needed in patients with concurrent liver disease. The multiple physiological roles of the liver places these patients at an increased risk of morbidity and mortality. Diseases necessitating surgery like gallstones and hernia are more common in patients with cirrhosis. Assessment of severity of liver dysfunction before surgery is important and the risk benefit of the procedure needs to be carefully assessed. The disease severity may vary from mild transaminase rise to decompensated cirrhosis. Surgery should be avoided if possible in the emergency setting, in the setting of acute and alcoholic hepatitis, in a patient of cirrhosis who is child class C or has a MELD score more than 15 or any patient with significant extrahepatic organ dysfunction. In this subset of patients, all possible means to manage these patients conservatively should be attempted. Modified Child-Pugh scores and model for end-stage liver disease (MELD) scores can predict mortality after surgery fairly reliably including nonhepatic abdominal surgery. Pre-operative optimization would include control of ascites, correction of electrolyte imbalance, improving renal dysfunction, cardiorespiratory assessment, and correction of coagulation. Tests of global hemostasis like thromboelastography and thrombin generation time may be more predictive of the risk of bleeding compared with the conventional tests of coagulation in patients with cirrhosis. Correction of international normalized ratio with fresh frozen plasma does not necessarily mean reduction of bleeding risk and may increase the risk of volume overload and lung injury. International normalized ratio liver may better reflect the coagulation status. Recombinant factor VIIa in patients with cirrhosis needing surgery needs further study. Intra-operatively, safe anesthetic agents like isoflurane and propofol with avoidance of hypotension are advised. In general, nonsteroidal anti-inflammatory drug (NSAIDs) and benzodiazepines should not be used. Intra-abdominal surgery in a patient with cirrhosis becomes more challenging in the presence of ascites, portal hypertension, and hepatomegaly. Uncontrolled hemorrhage due to coagulopathy and portal hypertension, sepsis, renal dysfunction, and worsening of liver failure contribute to the morbidity and mortality in these patients. Steps to reduce ascitic leaks and infections need to be taken. Any patient with cirrhosis undergoing major surgery should be referred to a specialist center with experience in managing liver disease. ( J CLIN EXP HEPATOL 2012;2:238-246)

show abstract

The Platelet and Platelet Function Testing in Liver Disease

Cited by 54 publications

References 57 publications

Karaciğer hastalıklarında pıhtılaşma-tromboz mekanizmasına neler oluyor?

Karaciğer hastalıklarında pıhtılaşma-tromboz mekanizmasına neler oluyor?

Bleeding and Clotting Disorders in Pediatric Liver Disease

Surgery in a Patient with Liver Disease

Contact Info

Product

Resources

About