Evidence of rebalanced coagulation in acute liver injury and acute liver failure as measured by thrombin generation

Mohamed Habib, Lara Roberts, Raj K. Patel, Julia Wendon, William Bernal, Roopen Arya*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    79 Citations (Scopus)

    Abstract

    Background & Aims

    Patients with liver disease often show profound abnormalities in their haemostatic system. Studies using thrombin generation demonstrate rebalanced coagulation in patients with chronic liver disease. Our aim was to evaluate the haemostatic profile in patients with acute liver injury/failure (ALI/ALF) compared with healthy controls.

    Methods

    Thrombin generation was measured in the presence and absence of thrombomodulin (TM) to activate protein C (PC) with endogenous thrombin potential (ETP; the area under the thrombin generation curve) a key parameter. Routine coagulation assays were also performed.

    Results

    Thirty two patients with ALI/ALF and 40 controls were recruited. Patients had grossly abnormal coagulation profiles with decreased pro- and anticoagulant factors compared with controls (P

    Conclusion

    ALI/ALF patients have normal ETP in the presence of TM. This supports rebalanced coagulation mediated by acquired PC resistance because of the reduction in PC, Factor V and concomitant increase in Factor VIII.

    Original languageEnglish
    Pages (from-to)672-678
    Number of pages7
    JournalLIVER INTERNATIONAL
    Volume34
    Issue number5
    DOIs
    Publication statusPublished - 1 May 2014

    Keywords

    • thrombin generation
    • coagulation
    • acute liver failure
    • acute liver injury
    • ACTIVATED PROTEIN-C
    • FACTOR-V
    • COAGULOPATHY
    • DISEASE
    • HEMOSTASIS
    • DISORDERS
    • CIRRHOSIS
    • PRESSURE
    • CAPACITY
    • PLASMA

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