Intact thrombin generation and decreased fibrinolytic capacity in patients with acute liver injury or acute liver failure

Journal of Thrombosis and Haemostasis : JTH
T LismanR T Stravitz

Abstract

It has been well established that hemostatic potential in patients with chronic liver disease is in a rebalanced status due to a concomitant decrease in pro- and antihemostatic drivers. The hemostatic changes in patients with acute liver injury/failure (ALI/ALF) are similar but not identical to the changes in patients with chronic liver disease and have not been studied in great detail. To assess thrombin generation and fibrinolytic potential in patients with ALI/ALF. We performed thrombin generation tests and clot lysis assays in platelet-poor plasma from 50 patients with ALI/ALF. Results were compared with values obtained in plasma from 40 healthy volunteers. The thrombin generation capacity of plasma from patients with ALI/ALF sampled on the day of admission to hospital was indistinguishable from that of healthy controls, provided thrombomodulin was added to the test mixture. Fibrinolytic capacity was profoundly impaired in patients with ALI/ALF on admission (no lysis in 73.5% of patients, compared with 2.5% of the healthy controls), which was associated with decreased levels of the plasminogen and increased levels of plasminogen activator inhibitor type 1. The intact thrombin generating capacity and the hypofibrinolytic sta...Continue Reading

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Citations

Feb 13, 2013·Current Opinion in Critical Care·Eva SchadenKlaus Goerlinger
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Dec 2, 2014·Clinics in Liver Disease·M Shadab Siddiqui, R Todd Stravitz
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Mar 28, 2021·Seminars in Thrombosis and Hemostasis·Fien A von Meijenfeldt, Ton Lisman
Apr 14, 2021·Journal of Hepatology·William Bernal, Mark J McPhail

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