Thrombocytopenia and coagulopathy in hepatopathy: an introduction into the issue

The liver is the key organ for blood coagulation processes. The liver has an effect on platelet count and their quality. Additionally, it is the organ where most coagulation and fibrinolytic factors as well as their inhibitors are synthesized. Degradation of activated coagulation and fibrinolytic factors also occurs in the liver. Likewise, endogenous heparin and what is called heparin-like substance may be released from the liver. Patients often do not bleed even in the presence of a substantial deficiency of procoagulation factors as this condition is associated with decreased levels of coagulation inhibitors while, in other cases, they do bleed for local causes (esophageal varices) even at relatively adequate levels of coagulation factors, or thrombocytopenia and thrombocypathy are at play. Appropriate assessment of blood coagulation status by an experienced hematologist will allow choosing a rational therapeutic option.

Keywords: liver failure; coagulation factors; coagulation inhibitors; fibrinolysis; thrombocytopathy; prothrombin time; DIC