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Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

    Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
    |March 26, 2016
    PubMed

    Insights

    Cirrhosis causes complex hemostatic alterations, rebalancing the blood clotting system. This consensus outlines optimal management for bleeding and thrombosis risks in cirrhotic patients.

    Area of Science:

    • Hepatology
    • Hematology
    • Internal Medicine

    Background:

    • Patients with cirrhosis exhibit altered hemostasis due to reduced pro-coagulant and anti-coagulant factors, leading to a rebalanced system.
    • Understanding these hemostatic perturbations is crucial for managing bleeding and thrombotic risks.

    Framework:

    • A consensus conference was convened by the Italian Association of the Study of the Liver (AISF) and the Italian Society of Internal Medicine (SIMI).
    • The process involved a literature review by experts, a formal consensus meeting, and grading of statements by evidence quality and recommendation strength.
    • An independent jury approved the final consensus statements.

    Implementation:

    • The consensus evaluates the strengths and weaknesses of current laboratory tests for assessing bleeding and thrombotic risk in cirrhosis.
    • It details the pathophysiology of hemostatic changes in liver cirrhosis.
    • The statements provide guidance on the optimal management of bleeding and thrombosis.

    Implications:

    • This consensus offers a framework for improved diagnosis and management of hemostatic disorders in cirrhotic patients.
    • It aims to enhance clinical decision-making regarding bleeding and thrombosis in liver cirrhosis.
    • The findings support evidence-based practice for managing hemostatic balance in this patient population.

    Keywords:
    BleedingCirrhosisHemostasisThrombosis

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