| 9 | Bleeding risk and thrombosis in cirrhosis:a paradox with a need to address them显示文摘Patients with cirrhosis have a state of“rebalanced hemostasis”where there is a simultaneous reduction in both qualitative and quantitative properties of procoagulants and anticoagulants,i.e.,platelets,fibrinogen,coagulation factors,protein C,S,and antithrombin and conversely,there is an increase in the levels of von Willebrand factor,endothelial factor VIII,tissue plasminogen activator(t-PA),and plasminogen activator inhibitor type 1(PAI-1)(1).Laboratory tests,such as INR,involving these coagulation proteins have been used for the prognostication of patients with cirrhosis/liver failure and have historically been part of several severity scores(2,3).Spontaneous bleeding due to clotting factor deficiencies is less frequent in the absence of mechanical trauma,while thrombosis is not uncommon and may merit anticoagulation therapy(4).However,the management of patients with cirrhosis with abnormalities in the hemostasis system is unclear.To meet this unmet need,the European Association for the Study of the Liver(EASL)developed new guidelines for the prevention and management of bleeding and thrombosis in patients with cirrhosis(5).The bleeding here is referred to mucocutaneous and visceral bleeding events. | Anand V.Kulkarni K.Rajender Reddy | 2023 | Hepatobiliary Surgery and Nutrition2023，12，3： | 0 |
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