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The liver has a major role in the maintenance of normal hemostasis. In addition to the synthesis of coagulation factors and hemostatic regulators, it acts as a clearance site for activated coagulation proteins. Because of a considerable hepatic functional reserve, coagulopathy tends not to occur until more than 80% of hepatic function is lost. Liver disease may present with hemorrhagic and/or thrombotic...
Liver disease impacts on both primary and secondary haemostatic mechanisms and historically these changes were thought to underpin the bleeding diathesis. However, bleeding complications in patients with liver disease are unpredictable, with the majority of haemorrhagic episodes occurring as a result of porto‐systemic varices. Thrombosis is an increasingly recognised complication and systemic hypercoagulability...
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