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Cirrhosis patients have a coagulopathy that is associated with decreased clot formation capacity

M-C Kleinegris1, M H A Bos, M Roest

  • 1Laboratory for Clinical Thrombosis and Hemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.

Journal of Thrombosis and Haemostasis : JTH
|August 22, 2014
PubMed

Insights

Cirrhosis patients exhibit a procoagulant plasma state but impaired whole blood clot formation. This study clarifies coagulopathy in cirrhosis, impacting thrombosis and bleeding risks.

Area of Science:

  • Hepatology
  • Hematology
  • Thrombosis Research

Background:

  • Coagulopathy in cirrhosis is complex, linked to both thrombosis and bleeding.
  • Understanding the balance of procoagulant and anticoagulant factors is crucial.

Purpose of the Study:

  • To investigate plasma thrombin generation and whole blood clot formation in cirrhosis patients.
  • To correlate these hemostatic parameters with cirrhosis severity.

Main Methods:

  • Assessed coagulation factors (FVIIa, FIXa, FXa complexes) and thrombin generation via calibrated automated thrombography.
  • Utilized ROTEM (Rotational Thromboelastometry) for whole blood clot formation and lysis analysis.
  • Included 73 cirrhosis patients (Child-Pugh A, B, C) and 20 healthy controls.

Main Results:

  • Observed increased FVIIa generation and moderately elevated FIXa-antithrombin complexes in cirrhosis patients.
  • Demonstrated increased thrombin generation potential correlating with cirrhosis severity.
  • Found delayed whole blood clot formation and reduced clot strength, worsening with cirrhosis severity.
  • Noted no significant differences in clot degradation (tPA-ROTEM parameters).

Conclusions:

  • Cirrhosis patients present a procoagulant plasma environment.
  • Despite procoagulant plasma, whole blood clot formation capacity is diminished.
  • Clot lysis resistance appears unaltered in cirrhosis patients.
Abstract

Keywords:
cirrhosishemostasishypercoagulabilitythrombinthromboelastometry

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