hematologic complications of hepatocellular failure

Pathology: 1) decreased synthesis of all procoagulant factors 2) congestive splenomegaly resulting in thrombocytopenia 3) qualitative platelet defect resulting in a bleeding time prolonged more than expected from degree of thrombocytopenia 4) dysfibrinogenemia causing a prolonged bleeding time 5) pathologic fibrinolysis secondary to failure to clear tissue plasminogen activator 6) decreased plasminogen activator inhibitor & alpha-2 plasmin inhibitor levels may also occur 7) disseminated intravascular coagulation (DIC) may complicate infections or peritoneal-venous shunts

References

Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998