Acquired Coagulation Disorders
LIVER
DISEASE
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.
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