Guidelines for the management of coagulation disorders in patients with cirrhosis.

Autor:	Aiza-Haddad I; Clínica de Enfermedades Hepáticas, Hospital Ángeles Lomas, Mexico City, Mexico. Electronic address: drignacioaiza@yahoo.com., Cisneros-Garza LE; Departamento de Gastroenterología y Hepatología, Hospital Christus Muguerza Alta Especialidad, Monterrey, Mexico., Morales-Gutiérrez O; Departamento de Gastroenterología y Hepatología, Hospital General de México «Dr. Eduardo Liceaga», Mexico City, Mexico., Malé-Velázquez R; Centro de Enfermedades Digestivas, Guadalajara, Mexico., Rizo-Robles MT; Departamento de Gastroenterología y Hepatología, Instituto Mexicano del Seguro Social Centro Médico Nacional «La Raza», Mexico City, Mexico., Alvarado-Reyes R; Departamento de Hepatología, Hospital San José Tec Salud, Monterrey, Mexico., Barrientos-Quintanilla LA; Departamento de Hepatología, Hospital San José Tec Salud, Monterrey, Mexico., Betancourt-Sánchez F; Centro de Enfermedades Digestivas, Guadalajara, Mexico., Cerda-Reyes E; Servicio de Gastroenterología, Hospital Central Militar, Mexico City, Mexico., Contreras-Omaña R; Centro de Investigación en Enfermedades Hepáticas y Gastroenterología (CIEHG) Pachuca, Hidalgo, México., Dehesa-Violante MB; Servicio de Hepatología, Hospital Santa Coleta, Ciudad de México, México., Flores-García NC; Escuela de Medicina y Ciencias de la Salud. Tecnológico de Monterrey, Monterrey Nuevo Leon, México., Gómez-Almaguer D; Clínica de Hematología «Gómez Almaguer», Monterrey, México., Higuera-de la Tijera MF; Departamento de Gastroenterología y Hepatología, Hospital General de México «Dr. Eduardo Liceaga», Mexico City, Mexico., Lira-Pedrin MA; Departamento de Gastroenterología, Endoscopía Digestiva, Motilidad y Hepatología, Centro Médico Corporativo Galeana, Tijuana, México., Lira-Vera JE; Departamento de Gastroenterología y Hepatología, Hospital General de México «Dr. Eduardo Liceaga», Mexico City, Mexico., Manzano-Cortés H; Servicio de Gastroenterología, Hospital Ángeles, Puebla, México., Meléndez-Mena DE; Hospital General de Especialidades «Maximino Ávila Camacho», IMSS, UMAE, Puebla, México., Muñoz-Ramírez MR; Departamento de Hepatología, Hospital San José Tec Salud, Monterrey, Mexico., Pérez-Hernández JL; Departamento de Gastroenterología y Hepatología, Hospital General de México «Dr. Eduardo Liceaga», Mexico City, Mexico., Ramos-Gómez MV; Departamento Hepatología, ISSSTE, Centro Médico Nacional «20 de noviembre», Ciudad de México, México., Sánchez-Ávila JF; Escuela de Medicina y Ciencias de la Salud. Tecnológico de Monterrey, Monterrey Nuevo Leon, México.
Jazyk:	angličtina
Zdroj:	Revista de gastroenterologia de Mexico (English) [Rev Gastroenterol Mex (Engl Ed)] 2024 Jan-Mar; Vol. 89 (1), pp. 144-162. Date of Electronic Publication: 2024 Apr 09.
DOI:	10.1016/j.rgmxen.2023.08.008
Abstrakt:	Coagulation management in the patient with cirrhosis has undergone a significant transformation since the beginning of this century, with the concept of a rebalancing between procoagulant and anticoagulant factors. The paradigm that patients with cirrhosis have a greater bleeding tendency has changed, as a result of this rebalancing. In addition, it has brought to light the presence of complications related to thrombotic events in this group of patients. These guidelines detail aspects related to pathophysiologic mechanisms that intervene in the maintenance of hemostasis in the patient with cirrhosis, the relevance of portal hypertension, mechanical factors for the development of bleeding, modifications in the hepatic synthesis of coagulation factors, and the changes in the reticuloendothelial system in acute hepatic decompensation and acute-on-chronic liver failure. They address new aspects related to the hemorrhagic complications in patients with cirrhosis, considering the risk for bleeding during diagnostic or therapeutic procedures, as well as the usefulness of different tools for diagnosing coagulation and recommendations on the pharmacologic treatment and blood-product transfusion in the context of hemorrhage. These guidelines also update the knowledge regarding hypercoagulability in the patient with cirrhosis, as well as the efficacy and safety of treatment with the different anticoagulation regimens. Lastly, they provide recommendations on coagulation management in the context of acute-on-chronic liver failure, acute liver decompensation, and specific aspects related to the patient undergoing liver transplantation. (Copyright © 2023 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.)
Databáze:	MEDLINE
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