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Letter to the Editor| Volume 77, ISSUE 3, P886-887, September 2022

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On coagulation in advanced chronic liver disease and the origin of freshwater eels

  • Mattias Mandorfer
    Affiliations
    Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

    Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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  • Bernhard Scheiner
    Affiliations
    Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

    Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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  • Ton Lisman
    Correspondence
    Corresponding author. Address: Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, BA44, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands; Tel.: +31-50-3619028, fax: +31-50-3632796.
    Affiliations
    Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Published:June 07, 2022DOI:https://doi.org/10.1016/j.jhep.2022.05.029
On coagulation in advanced chronic liver disease and the origin of freshwater eels
Previous ArticleCirrhosis: What are all those factor VIII and protein C for?
Next ArticleA good step toward low-cost prognostication of liver-related outcome awaits more validation
      We would like to thank Dr. Tripodi for his interest in our work.
      • Scheiner B.
      • Balcar L.
      • Nussbaumer R.J.
      • Weinzierl J.
      • Paternostro R.
      • Simbrunner B.
      • et al.
      Factor VIII/protein C ratio independently predicts liver-related events but does not indicate a hypercoagulable state in ACLD.
      J Hepatol. 2022; 76: 1090-1099

      Linked Article

      • Cirrhosis: What are all those factor VIII and protein C for?
        Journal of HepatologyVol. 77Issue 3
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          Over the last decades our understanding of cirrhotic coagulopathy has undergone considerable changes. Clinical, experimental, and pathophysiological observations helped us to view cirrhosis not as the epitome of acquired bleeding disorders, but as a disease characterized by rebalanced hemostasis and possibly even the increased risk of thrombosis.1 Scheiner et al. recently published an interesting paper on this topic.2 Based on retrospective evaluation of coagulation biomarkers and clinical observations, the authors conclude that the factor (F)VIII/protein C(PC) ratio in cirrhosis is independently associated with liver-related events/death.
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      • Factor VIII/protein C ratio independently predicts liver-related events but does not indicate a hypercoagulable state in ACLD
        Journal of HepatologyVol. 76Issue 5
        • Preview
          It has been suggested that the ratio of procoagulant factor VIII to anticoagulant protein C (FVIII/PC) reflects the hemostatic equilibrium. Moreover, FVIII/PC predicted decompensation/death in a small study not accounting for portal hypertension severity. We investigated (i) the prognostic value of FVIII/PC (outcome-cohort) and (ii) whether FVIII/PC reflects the hypercoagulable state (assessed by thrombomodulin-modified thrombin generation assay [TM-TGA]) or the risk of bleeding/thrombotic events in patients undergoing hepatic venous pressure gradient (HVPG) measurement during follow-up.
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      References

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        • Simbrunner B.
        • et al.
        Factor VIII/protein C ratio independently predicts liver-related events but does not indicate a hypercoagulable state in ACLD.
        J Hepatol. 2022; 76: 1090-1099
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      Article info

      Publication history

      Published online: June 07, 2022
      Accepted: May 19, 2022
      Received: May 18, 2022

      Footnotes

      Author names in bold designate shared co-first authorship

      Identification

      DOI: https://doi.org/10.1016/j.jhep.2022.05.029

      Copyright

      © 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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