Review of chronic liver disease

The Bottom Line: Chronic liver disease is defined by clinical bleeding and decreased levels of most procoagulant factors Exceptions being factor VIII and von Willebrand factor. Decreased levels of the procoagulants are associated by decrease in the level of naturally occurring anticoagulants such as antithrombin and protein C

Tripodi, Armando The coagulopathy of chronic liver disease. The New England journal of medicine 2011 vol:365 iss:2 pg:147 -156

End-stage liver disease patients have marked bleeding symptoms, especially in the gastrointestinal tract. Evaluation of this bleeding tendency solely on the basis of abnormal levels of the conventional coagulation biomarkers should be reassessed.

Table 2. Underlying Conditions That Explain the Bleeding Tendency in Patients with Decompensated Chronic Liver Disease page 152

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