[THE MODERN CONCEPTS OF HEMOSTASIS SYSTEM UNDER CHRONIC DISEASES OF LIVER: THE PUBLICATIONS REVIEW]

Area of Science:

• Hematology
• Hepatology
• Coagulation Science

Context:

• Chronic liver disease significantly disrupts the hemostasis system, impacting both primary and secondary coagulation.
• Imbalances in hemostasis can lead to either bleeding or thrombosis in patients with liver conditions.
• Traditional screening tests like prothrombin time and activated partial thromboplastin time show poor correlation with actual bleeding events.

Purpose:

• To highlight the limitations of current coagulation screening tests in patients with chronic liver disease.
• To address the under-explored issue of hemostasis disorders in rare liver diseases, such as glycogenous disease.
• To emphasize the need for novel diagnostic biomarkers and monitoring tools for hemostasis in liver disease.

Summary:

• Coagulation imbalance in chronic liver disease affects hemostasis, leading to potential bleeding or thrombosis.
• Existing screening tests (prothrombin time, activated partial thromboplastin time) have limited predictive value for bleeding risk.
• Research increasingly questions the utility of these tests and associated therapeutic strategies.
• Hemostasis disorders in rare liver diseases remain largely unexplored, with specific examples like glycogenous disease showing early-onset bleeding due to platelet dysfunction and von Willebrand factor issues.
• Significant unresolved issues in understanding hemostasis disorders hinder the development of diagnostic biomarkers for liver disease patients.

Impact:

• Challenges the established relationship between screening test results and bleeding risk in liver disease.
• Underscores the urgent need for developing new diagnostic and monitoring tools for coagulopathies in liver disease.
• Calls for further research into hemostasis in rare liver diseases to improve patient management and outcomes.