Lab monitoring of hemostatic rebalancing in patients with end-stage liver disease and assessment of bleeding and thrombotic risk
10.3760/cma.j.cn114452-20250311-00146
- VernacularTitle:终末期肝病患者止血再平衡的实验监测及出血与血栓风险评估
- Author:
Xiaojing ZHAO
1
;
Jianlong MEN
1
;
Zhubo ZHANG
1
;
Hongyan ZHANG
1
;
Yang LI
1
;
Jing REN
1
Author Information
1. 天津医科大学总医院精准医学中心，天津 300052
- Publication Type:Journal Article
- Keywords:
Liver diseases;
Rebalanced hemostasis;
Laboratory testing;
Bleeding;
Venous thromboembolism;
Portal vein thrombosis
- From:
Chinese Journal of Laboratory Medicine
2025;48(12):1616-1622
- CountryChina
- Language:Chinese
-
Abstract:
In the progression process of liver diseases, pathological changes occur in the vascular endothelium, platelets, coagulation, anticoagulation, fibrinolysis systems of patients, and "rebalancd haemostasis" is formed. The coexistence of hypocoagulation and hypercoagulation tendency in the peripheral blood of patients made the laboratory testing data complex and difficult to interpret, especially prothrombin time and activated partial thromboplastin time could not truly reflect the net effect of haemostasis disorder in patients with liver diseases, which often led to misjudgment and overtreatment by doctors and led to adverse clinical consequences. In recent years, thromboelastography, rotational thromboelastometry and thrombin generation assay had been used to assess bleeding risk in patients with liver diseases and had made progress in transfusion management. On the other hand, von Willebrand factor and thrombospondin type 1 motif member 13 has been shown to be closely related to the progression of liver diseases and could warn the adverse clinical outcomes effectively.
