Lisman, T and Ariens, RAS orcid.org/0000-0002-6310-5745 (2016) Alterations in Fibrin Structure in Patients with Liver Diseases. Seminars in Thrombosis and Hemostasis, 42 (4). pp. 389-396. ISSN 0094-6176
Abstract
The hemostatic balance in patients with liver diseases is relatively well preserved due to concomitant alterations in pro- and antihemostatic pathways. Thrombin generation studies support the notion of hemostatic competence in liver diseases, but in such tests alterations in fibrinogen level and function are not taken into account. We have recently studied structural and functional properties of the fibrin clot in patients with liver diseases. Although we have confirmed previous findings that hypersialylation of the fibrinogen molecule in patients with liver diseases contributes to a defective fibrinogen-to-fibrin conversion, we have found that once the clot has been formed, it has a thrombogenic nature as assessed by permeability assays. These thrombogenic properties of the fibrin clot in cirrhosis relate to incompletely characterized intrinsic changes in the fibrinogen molecule, which may include oxidation and hypersialylation. In addition, in patients with nonalcoholic fatty liver disease thrombogenic properties of the fibrin clot are not only due to liver disease but also to obesity and the metabolic syndrome. During liver transplantation, the clot normalizes and becomes increasingly permeable, and the functional properties of the fibrin clot are markedly normalized by fibrinogen concentrate, when added to plasma samples in vitro. These new insights in the functional properties of the fibrin clot in patients with liver diseases facilitate a more rational approach to treatment and prevention of both bleeding and thrombotic complications.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | cirrhosis; nonalcoholic fatty liver disease; liver transplantation; fibrinogen; fibrin |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Discovery & Translational Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 21 Nov 2018 16:13 |
Last Modified: | 21 Nov 2018 16:13 |
Published Version: | https://doi.org/10.1055/s-0036-1572327 |
Status: | Published |
Publisher: | Georg Thieme Verlag |
Identification Number: | 10.1055/s-0036-1572327 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:138875 |