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Review
. 2020 Dec 28;8(4):407-413.
doi: 10.14218/JCTH.2020.00058. Epub 2020 Oct 10.

Clinical Considerations of Coagulopathy in Acute Liver Failure

Ahyoung Kim  1 , Bolin Niu  2 , Tinsay Woreta  1 , Po-Hung Chen  1
Affiliations
Review

Clinical Considerations of Coagulopathy in Acute Liver Failure

Ahyoung Kim et al. J Clin Transl Hepatol. .

Abstract

Acute liver failure (ALF) is the rapid onset of severe liver dysfunction, defined by the presence of hepatic encephalopathy and impaired synthetic function (international normalized ratio of ≥1.5) in the absence of underlying liver disease. The elevated international normalized ratio value in ALF is often misinterpreted as an increased hemorrhagic tendency, which can lead to inappropriate, prophylactic transfusions of blood products. However, global assessments of coagulopathy via viscoelastic tests or thrombin generation assay suggest a reestablished hemostatic, or even hypercoagulable, status in patients with ALF. Although the current versions of global assays are not perfect, they can provide more nuanced insights into the hemostatic system in ALF than the conventional measures of coagulopathy.

Keywords: Acute liver failure; Coagulopathy; Thrombin generation assay; Viscoelastic test.

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Conflict of interest statement

The authors have no conflict of interests related to this publication.

Figures

Fig. 1.
Fig. 1.. Coagulation cascade in acute liver failure
See this image and copyright information in PMC

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