Guidelines for the management of coagulation disorders in patients with cirrhosis

Copyright © 2023 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved..

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.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:89

Enthalten in:

Revista de gastroenterologia de Mexico (English) - 89(2024), 1 vom: 10. Jan., Seite 144-162

Sprache:

Englisch

Beteiligte Personen:

Aiza-Haddad, I [VerfasserIn]
Cisneros-Garza, L E [VerfasserIn]
Morales-Gutiérrez, O [VerfasserIn]
Malé-Velázquez, R [VerfasserIn]
Rizo-Robles, M T [VerfasserIn]
Alvarado-Reyes, R [VerfasserIn]
Barrientos-Quintanilla, L A [VerfasserIn]
Betancourt-Sánchez, F [VerfasserIn]
Cerda-Reyes, E [VerfasserIn]
Contreras-Omaña, R [VerfasserIn]
Dehesa-Violante, M B [VerfasserIn]
Flores-García, N C [VerfasserIn]
Gómez-Almaguer, D [VerfasserIn]
Higuera-de la Tijera, M F [VerfasserIn]
Lira-Pedrin, M A [VerfasserIn]
Lira-Vera, J E [VerfasserIn]
Manzano-Cortés, H [VerfasserIn]
Meléndez-Mena, D E [VerfasserIn]
Muñoz-Ramírez, M R [VerfasserIn]
Pérez-Hernández, J L [VerfasserIn]
Ramos-Gómez, M V [VerfasserIn]
Sánchez-Ávila, J F [VerfasserIn]

Links:

Volltext

Themen:

Bleeding
Chronic liver disease
Cirrhosis
Cirrosis
Enfermedad hepática crónica
Hemorragia
Hemostasia
Hemostasis
Practice Guideline
Thrombosis
Trombosis

Anmerkungen:

Date Completed 22.04.2024

Date Revised 22.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.rgmxen.2023.08.008

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370893328