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Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo
Published on: August 4, 2018
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[Coagulation management in patients with liver disease]
A Bienholz1,2, A Canbay3, F H Saner4
1Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland. anja.bienholz@uk-essen.de.
Summary
Advanced liver disease disrupts blood clotting, causing both bleeding and clotting risks. New bedside tests improve diagnosis and management of these hepatic coagulopathies, reducing blood product transfusions.
Area of Science:
- Hepatology and Coagulation Science
Background:
- End-stage liver disease (ESLD) presents complex hemostatic alterations, leading to bleeding or thromboembolic complications.
- Standard laboratory values (SLVs) inadequately assess the pro- and anticoagulant balance in ESLD.
- SLVs fail to predict bleeding risks in acute liver failure and decompensated liver cirrhosis.
Purpose of the Study:
- To review the pathophysiology of hemostasis in advanced liver insufficiency.
- To discuss novel diagnostic tools for hepatic coagulopathies.
- To explore current coagulation management strategies in this patient group.
Main Methods:
- Utilizing bedside coagulation diagnostics like thrombelastometry/thrombelastography.
- Employing multiple electrode aggregometry for platelet function analysis.
- Selective measurement of individual coagulation factors.
Main Results:
- Targeted, causal therapy of hepatic coagulopathies is enabled by advanced diagnostics.
- Coagulation management guided by new devices has reduced allogeneic blood product transfusions.
- Reduced transfusions may mitigate associated adverse effects.
Conclusions:
- Advanced liver disease significantly impacts hemostasis.
- Novel diagnostic and management approaches offer improved patient care.
- Current strategies focus on precise coagulation assessment and targeted interventions.
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