Liver Disease and Hemostasis (Review) Part 2. Cholestatic Liver Disease and Hemostasis
https://doi.org/10.15360/1813-9779-2019-6-80-93
Abstract
The presence or development of liver disorders can significantly complicate the course of critical illness and terminal conditions. Systemic hemostatic disorders are common in Intensive Care Units patients with cholestatic liver diseases, so the study of the mechanisms of their development can contribute to the understanding of the development of multiorgan failure in critical illness.
The review discusses current data on changes in hemostatic parameters in patients with cholestatic liver diseases, proposes a mechanism for the development of such disorders, which involve interactions of phospholipids with platelet and endotheliocyte membranes. It is suggested that a trend for thrombosis in patients with cholestatic liver disease is due to increased accumulation of bile acids in the systemic circulation. Available data demonstrate that the antiphospholipid syndrome may predispose to the formation of blood clots due to alterations of phospholipid composition of membranes of platelets and vascular endothelial cells by circulating antiphospholipid antibodies. Clarifying the mechanisms contributing to changes of the blood coagulation system parameters in liver disorders will aid to development of optimal correction of hemostatic disorders in patients with chronic liver diseases.
About the Authors
Vasiliy I. Reshetnyak
A. I. Evdokimov Moscow State University of medicine and dentistry, Ministry of Health of Russia
Russian Federation
20 Delegatskaya Str., Build 1, 127473 Moscow
Russian Federation
20 Delegatskaya Str., Build 1, 127473 Moscow
Igor V. Maev
A. I. Evdokimov Moscow State University of medicine and dentistry, Ministry of Health of Russia
Russian Federation
20 Delegatskaya Str., Build 1, 127473 Moscow
Russian Federation
20 Delegatskaya Str., Build 1, 127473 Moscow
Tatiana M. Reshetnyak
V. A. Nasonova Research Institute of Rheumatology
Russian Federation
34A Kashirskoye highway, Moscow 115522
Russian Federation
34A Kashirskoye highway, Moscow 115522
Sergei V. Zhuravel
N. V. Sklifosovsky Research Institute of Emergency Care, Moscow Healthcare Department
Russian Federation
3 Bolshaya Sukharevskaya Square, Moscow 129090
Russian Federation
3 Bolshaya Sukharevskaya Square, Moscow 129090
Vladimir M. Pisarev
V. A. Negovsky Research Institute of General Reanimatology, Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Russian Federation
25 Petrovka Str., Build. 2, 107031 Moscow
Russian Federation
25 Petrovka Str., Build. 2, 107031 Moscow
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Reshetnyak V.I., Maev I.V., Reshetnyak T.M., Zhuravel S.V., Pisarev V.M. Liver Disease and Hemostasis (Review) Part 2. Cholestatic Liver Disease and Hemostasis. General Reanimatology. 2019;15(6):80-93. https://doi.org/10.15360/1813-9779-2019-6-80-93
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