Normal to increased thrombin generation in patients undergoing liver transplantation despite prolonged conventional coagulation tests

Journal of Hepatology
Ton LismanRobert J Porte

Abstract

Patients with liver disease often show substantial changes in their hemostatic system, which may aggravate further during liver transplantation. Recently, thrombin generation in patients with stable disease was shown to be indistinguishable from controls provided thrombomodulin, the natural activator of the anticoagulant protein C system, was added to the plasma. These results indicated that the hemostatic balance is preserved in patients with liver disease, despite conventional coagulation tests suggest otherwise. Here we examined thrombin generation profiles in serial plasma samples taken from ten consecutive patients undergoing liver transplantation. At all time points, the endogenous thrombin potential (ETP) was slightly lower compared to healthy volunteers, despite substantially prolonged PT and APTT values. However, when thrombin generation was tested in the presence of thrombomodulin, the ETP was equal to or even higher than that in healthy subjects. In fact, thrombin generation was hardly affected by thrombomodulin, while thrombin generation in healthy subjects decreased profoundly upon the addition of thrombomodulin. In patients undergoing liver transplantation, efficient thrombin generation in the presence of thrombom...Continue Reading

References

Sep 1, 1990·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·R L StahlW D Warren
Sep 19, 2003·Pathophysiology of Haemostasis and Thrombosis·H C HemkerS Béguin
Feb 24, 2005·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Armando TripodiPier Mannuccio Mannucci
Dec 31, 2005·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Luc MassicotteAndré Roy
Jun 27, 2006·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Ton LismanFrank W G Leebeek
Jul 28, 2006·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Armando TripodiPier Mannuccio Mannucci
Sep 29, 2006·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Stephen H CaldwellUNKNOWN Coagulation in Liver Disease Group
Apr 26, 2007·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Marco VivarelliAntonio D Pinna
Jun 27, 2007·Alimentary Pharmacology & Therapeutics·A TripodiA J Sanyal
Aug 8, 2008·Current Opinion in Organ Transplantation·Nienke WarnaarRobert J Porte
Aug 12, 2008·Thrombosis Research·Dougald M Monroe
Sep 18, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Ton Lisman, Robert J Porte
May 9, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·I T A PereboomT Lisman

❮ Previous
Next ❯

Citations

Jul 15, 2011·The New England Journal of Medicine·Armando Tripodi, Pier Mannuccio Mannucci
Apr 12, 2014·Transfusion Medicine Reviews·Pepijn D WeederTon Lisman
Jul 11, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Nicolas M Intagliata, Stephen H Caldwell
Jan 16, 2015·American Journal of Respiratory and Critical Care Medicine·Karin RuitenbeekTon Lisman
Oct 1, 2013·Journal of Critical Care·Susan K Picoli-QuainoErich V De Paula
Jun 6, 2012·Transplantation Proceedings·G WagenerR N Sladen
Sep 2, 2015·Journal of Hepatology·Pierre-Emmanuel RautouNigel Mackman
May 4, 2013·Liver International : Official Journal of the International Association for the Study of the Liver·Susan V MallettAndrew K Burroughs
Nov 3, 2010·Journal of Thrombosis and Haemostasis : JTH·A TripodiP M Mannucci
May 23, 2013·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Dominik KrzanickiSusan Mallett
Jul 7, 2011·Journal of Thrombosis and Haemostasis : JTH·A TripodiD C Valla
Jun 26, 2012·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Shen-Chih WangMei-Yung Tsou
Feb 10, 2012·Journal of Veterinary Emergency and Critical Care·Carrie KavanaghCynthia R L Webster
Mar 16, 2013·Liver International : Official Journal of the International Association for the Study of the Liver·Freeha ArshadRobert J Porte
Jul 19, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Sumeet K AsraniPatrick S Kamath
Apr 1, 2016·Anaesthesia·M A E Ramsay, J F Trotter
Apr 16, 2013·Journal of Hepatology·Armando TripodiPier Mannuccio Mannucci
Mar 27, 2015·Journal of Thrombosis and Haemostasis : JTH·M C A MüllerN P Juffermans
Nov 6, 2014·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Nobuhisa AkamatsuNorihiro Kokudo
Aug 1, 2015·Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association·Tammy T HshiehVinay Sundaram
Jun 28, 2012·Journal of Hepatology·Banwari AgarwalAndrew Burroughs
Jun 16, 2010·Journal of Hepatology·Ton LismanUNKNOWN Coagulation in Liver Disease Study Group
Jul 22, 2010·Journal of Hepatology·Armando TripodiPier Mannuccio Mannucci
May 6, 2015·Medizinische Klinik, Intensivmedizin und Notfallmedizin·A BienholzF H Saner
Sep 12, 2014·Neurocritical Care·Andrew M NaidechUNKNOWN Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring
Sep 25, 2014·Arab Journal of Gastroenterology : the Official Publication of the Pan-Arab Association of Gastroenterology·Mohamed A El BoklDina Khattab
Oct 19, 2016·Journal of Hepatology·Wilma PotzeTon Lisman
Nov 9, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Michael J R Desborough, Vipul Jairath
Sep 7, 2016·Journal of Vascular and Interventional Radiology : JVIR·Gia A DeAngelisStephen H Caldwell
Mar 26, 2016·Archives of Disease in Childhood·Maria MagnussonPaul Monagle
Oct 23, 2016·Journal of Hepatology·Wilma PotzeTon Lisman
Nov 2, 2016·The American Journal of Gastroenterology·Armando TripodiStephen H Caldwell
Dec 14, 2016·British Journal of Anaesthesia·L A TafurJ C Garcia-Valdecasas

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Related Papers

Hepatology : Official Journal of the American Association for the Study of Liver Diseases
Armando TripodiPier Mannuccio Mannucci
Journal of Hepatology
Ton LismanCoagulation in Liver Disease Study Group
Liver International : Official Journal of the International Association for the Study of the Liver
Freeha ArshadRobert J Porte
© 2021 Meta ULC. All rights reserved