Disseminated intravascular coagulation and cirrhotic coagulopathy: overlap and differences. The current state of knowledge. Communication from the SSC of the ISTH.

Autor:	Scarlatescu E; University of Medicine and Pharmacy 'Carol Davila,' Bucharest, Romania; Department of Anaesthesia and Intensive Care, Fundeni Clinical Institute, Bucharest, Romania. Electronic address: katyscarlatescu@yahoo.com., Levy JH; Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC, USA., Moore H; AdventHealth Transplant Institution, Porter, Denver, CO, USA., Thachil J; Department of Haematology, Manchester University Hospital, Manchester, United Kingdom; MAHSC Professor, The University of Manchester, Manchester, United Kingdom., Iba T; Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Roberts LN; King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital, London, United Kingdom., Lisman T; Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of thrombosis and haemostasis : JTH [J Thromb Haemost] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.
DOI:	10.1016/j.jtha.2024.11.019
Abstrakt:	Patients with disseminated intravascular coagulation (DIC) have decreasing plasma levels of coagulation factors and platelet counts with increased levels of D-dimers. Standard laboratory tests are used clinically to diagnose DIC and quantify the severity of the disease. In patients with cirrhosis, liver-derived plasma coagulation factor levels are reduced due to decreased hepatic synthesis, further exacerbated by extravascular redistribution of these proteins, causing prolongation of routine diagnostic coagulation tests. Platelets are often decreased in cirrhosis due to reduced production and portal hypertension, resulting in hypersplenism and sequestration. Patients with cirrhosis frequently have elevated fibrin/fibrinogen degradation products levels without having acute medical decompensation. As a result, these patients commonly meet the laboratory criteria of DIC. However, it has been debated whether laboratory-assessed DIC is present in patients with cirrhosis and if it has clinical relevance. In this communication, we review hemostatic features in cirrhosis and DIC, examine published studies that evaluate the activation of hemostasis in patients with cirrhosis, and highlight future directions for research. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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