[Introduction to the study of hemostasis in cirrhotic patients (author's transl)]

Any diffuse lesion of the liver induces permanent hypercoagulation with subsequent permanent lysis and possible consumption or DIVC/Hemostasis depends on two distinct mechanisms: the platelets, whose functional activity is more important than numbers, and the coagulolytic equilibrium of the plasma. Apart from the activating and inhibiting enzymes of coagulation and lysis, the lungs and liver play an important role. The lungs filter and then determine lysis of the corpuscular agglomerates. The liver produces epuration of the activated factors and prothrombinase, as well as the plasminogen activator. Except in extremely severe cases, however, these functions are rarely involved. Investigations must be complete and include a test of platelet aggregation, a TEG on total blood to analyze whole coagulation, and tests for consumption and lysis. Coagulation and bleeding time tests are of great value during severe hemorrhagic attacks. Pathological examination should evaluate the condition of the vascular state and, more particularly, the presence of fibrin thrombi with the appropriate methods.