Related Experiment Video
Updated: May 11, 2026

Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo
Published on: August 4, 2018
Clinical utility of viscoelastic tests of coagulation in patients with liver disease
Susan V Mallett1, Pratima Chowdary, Andrew K Burroughs
1Department of Anaesthesia, Royal Free London NHS Foundation Trust, London, UK.
Abstract:
The prothrombin time (PT) and international normalised ratio (INR) are used in scoring systems (Child-Pugh, MELD, UKELD) in chronic liver disease and as a prognostic tool and for dynamic monitoring of hepatic function in acute liver disease. These tests are known to be poor predictors of bleeding risk in liver disease; however, they continue to influence clinical management decisions. Recent work on coagulation in liver disease, in particular thrombin generation studies, has led to a paradigm shift in our understanding and it is now recognised that haemostasis is relatively well preserved. Whole blood global viscoelastic tests (TEG(®) /ROTEM(®) ) produce a composite dynamic picture of the entire coagulation process and have the potential to provide more clinically relevant information in patients with liver disease. We performed a systematic review of all relevant studies that have used viscoelastic tests (VET) of coagulation in patients with liver disease. Although many studies are observational and small in size, it is clear that VET provide additional information that is in keeping with the new concepts of how coagulation is altered in these patients. This review provides the basis for large scale, prospective outcome studies to establish the clinical value of these tests.
Related Concept Videos
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Cirrhosis II: Pathophysiology
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

