Hypercoagulability in end-stage liver disease: Prevalence and its correlation with severity of liver disease and portal vein thrombosis

Ashish Singhal, Andreas Karachristos, Michael Bromberg, Ellen Daly, Manoj Maloo, Ashok Kumar Jain

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Contrary to well-recognized bleeding diathesis in chronic liver disease, thrombotic events can occur in these patients due to reduction or loss of synthesis of anticoagulant proteins. Forty-seven consecutive patients with end-stage liver disease (ESLD) were investigated for activity of protein C, protein S, antithrombin, and factor V Leiden mutation. Forty-two (89.4%) patients had low levels of at least 1 while 33 (70.2%) patients were deficient for all anticoagulant proteins studied. Forty-six (97.9%) patients were negative for factor V Leiden mutation. The deficiencies were more marked in hepatitis C virus-positive patients and patients with model for end-stage liver disease (MELD) score >15. Six (12.8%) patients had portal vein thrombosis (PVT), and all had diminished protein S activity. In conclusions, deficiency of anticoagulant proteins occur in early phase of chronic liver disease. The severity of deficiency is proportional to the severity of liver disease. Despite the high prevalence of hypercoagulability, the incidence of PVT is low. Further studies with larger cohort of patients are needed to support these conclusions and to study other associated factors.

Original languageEnglish (US)
Pages (from-to)594-598
Number of pages5
JournalClinical and Applied Thrombosis/Hemostasis
Volume18
Issue number6
DOIs
StatePublished - Nov 2012

All Science Journal Classification (ASJC) codes

  • Hematology

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