TY - JOUR T1 - Cirrhotic coagulopathy: A rebalanced hemostasis JF - Cleveland Clinic Journal of Medicine JO - Cleve Clin J Med SP - 523 LP - 533 DO - 10.3949/ccjm.89a.21018 VL - 89 IS - 9 AU - Achintya D. Singh AU - Simon R. Mucha AU - Christina C. Lindenmeyer Y1 - 2022/09/01 UR - http://www.ccjm.org/content/89/9/523.abstract N2 - 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. ER -