Acquired Coagulation Disorders
With the exception of factor VIII, most blood coagulation fac-tors are synthesized in the liver. Therefore, hepatic dysfunction can result in diminished amounts of the factors needed to maintain coagula-tion and hemostasis. Prolongation of the PT, unless it is caused by vitamin K deficiency, may indicate severe hepatic dysfunction. Although minor bleeding is common (eg, ecchymoses), these pa-tients are also at risk for significant bleeding, related especially to trauma or surgery. Transfusion of fresh frozen plasma may be re-quired to replace clotting factors and to prevent or stop bleeding. Patients may also have life-threatening hemorrhage from peptic ulcers or esophageal varices. In these cases, replacement with fresh frozen plasma, PRBCs, and platelets is usually required.