PT  - JOURNAL ARTICLE
AU  - Achintya D. Singh
AU  - Simon R. Mucha
AU  - Christina C. Lindenmeyer
TI  - Cirrhotic coagulopathy: A rebalanced hemostasis
AID  - 10.3949/ccjm.89a.21018
DP  - 2022 Sep 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 523--533
VI  - 89
IP  - 9
4099  - http://www.ccjm.org/content/89/9/523.short
4100  - http://www.ccjm.org/content/89/9/523.full
SO  - Cleve Clin J Med2022 Sep 01; 89
AB  - Cirrhosis has been regarded as a hypocoagulable state associated with an increased risk of bleeding. But patients with cirrhosis also have a high incidence of thrombotic complications, challenging this dogma. We now recognize that in cirrhosis there is a simultaneous decrease in both clotting and anticlotting factors, leading to a new equilibrium. Conventional coagulation tests such as the platelet count and prothrombin time do not assess the reduced anticoagulation factors in cirrhosis and overestimate the bleeding risk, and any intervention based on these test results can lead to thrombotic complications. This article reviews the changes in hemostasis associated with cirrhosis, newer tests for assessing coagulation, and preprocedural minimization of coagulopathy.