I Aiza-Haddad, L E Cisneros-Garza, O Morales-Gutiérrez, R Malé-Velázquez, M T Rizo-Robles, R Alvarado-Reyes, L A Barrientos-Quintanilla, F Betancourt-Sánchez, E Cerda-Reyes, R Contreras-Omaña, M B Dehesa-Violante, N C Flores-García, D Gómez-Almaguer, M F Higuera-de la Tijera, M A Lira-Pedrin, J E Lira-Vera, H Manzano-Cortés, D E Meléndez-Mena, M R Muñoz-Ramírez, J L Pérez-Hernández, M V Ramos-Gómez, J F Sánchez-Ávila
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...
April 9, 2024: Revista de Gastroenterología de México