Coagulopathy Before and After Liver Transplantation: From the Hepatic to the Systemic Circulatory Systems

Jonathan Stine, Patrick G. Northup

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

The hemostatic environment in patients with cirrhosis is a delicate balance between prohemostatic and antihemostatic factors. There is a lack of effective laboratory measures of the hemostatic system in patients with cirrhosis. Many are predisposed to pulmonary embolus, deep vein thrombosis, and portal vein thrombosis in the pretransplantation setting. This pretransplantation hypercoagulable milieu seems to extend for at least several months post-transplantation. Patients with nonalcoholic fatty liver disease, inherited thrombophilia, portal hypertension in the absence of cirrhosis, and hepatocellular carcinoma often require individualized approach to anticoagulation. Early reports suggest a potential role for low-molecular-weight heparins and direct-acting anticoagulants.

Original languageEnglish (US)
Pages (from-to)253-274
Number of pages22
JournalClinics in Liver Disease
Volume21
Issue number2
DOIs
StatePublished - May 1 2017

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Cardiovascular System
Liver Transplantation
Fibrosis
Hemostatics
Liver
Thrombophilia
Low Molecular Weight Heparin
Portal Hypertension
Portal Vein
Embolism
Venous Thrombosis
Anticoagulants
Hepatocellular Carcinoma
Thrombosis
Transplantation
Lung

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

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title = "Coagulopathy Before and After Liver Transplantation: From the Hepatic to the Systemic Circulatory Systems",
abstract = "The hemostatic environment in patients with cirrhosis is a delicate balance between prohemostatic and antihemostatic factors. There is a lack of effective laboratory measures of the hemostatic system in patients with cirrhosis. Many are predisposed to pulmonary embolus, deep vein thrombosis, and portal vein thrombosis in the pretransplantation setting. This pretransplantation hypercoagulable milieu seems to extend for at least several months post-transplantation. Patients with nonalcoholic fatty liver disease, inherited thrombophilia, portal hypertension in the absence of cirrhosis, and hepatocellular carcinoma often require individualized approach to anticoagulation. Early reports suggest a potential role for low-molecular-weight heparins and direct-acting anticoagulants.",
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Coagulopathy Before and After Liver Transplantation : From the Hepatic to the Systemic Circulatory Systems. / Stine, Jonathan; Northup, Patrick G.

In: Clinics in Liver Disease, Vol. 21, No. 2, 01.05.2017, p. 253-274.

Research output: Contribution to journalReview article

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AU - Northup, Patrick G.

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AB - The hemostatic environment in patients with cirrhosis is a delicate balance between prohemostatic and antihemostatic factors. There is a lack of effective laboratory measures of the hemostatic system in patients with cirrhosis. Many are predisposed to pulmonary embolus, deep vein thrombosis, and portal vein thrombosis in the pretransplantation setting. This pretransplantation hypercoagulable milieu seems to extend for at least several months post-transplantation. Patients with nonalcoholic fatty liver disease, inherited thrombophilia, portal hypertension in the absence of cirrhosis, and hepatocellular carcinoma often require individualized approach to anticoagulation. Early reports suggest a potential role for low-molecular-weight heparins and direct-acting anticoagulants.

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