Hemostatic changes in patients with liver disease and in patients with COVID-19
Hemostatic changes in patients with liver disease and in patients with COVID-19
The liver plays a vital role in our coagulation system and is responsible for the production and clearance of most of the coagulation proteins and regulation of platelets. Hence, liver injury or disease results in complex changes in the coagulation system of patients. It remains challenging to predict and prevent bleeding and thrombotic complications in patients with liver disease.
The aim of this thesis of Fien von Meijenfeldt was to study the role of the coagulation system in bleeding and thrombotic complications in patients with liver disease and in progression of liver disease. I conducted studies on the effect of blood product transfusion and anticoagulant medications on the coagulation status of patients with liver disease.
Moreover, we showed that portal vein thrombosis, the most common thrombotic complication of liver disease, does not always consist of classic thrombosis, but is characterized by thickening of the inner vessel wall of the portal vein, making it an interesting novel target for prevention and treatment of portal vein thrombosis. In an experimental study of acute liver failure I showed that treatment with anticoagulant medication resulted in significantly decreased liver injury.
Future studies should focus on prevention of thrombosis in liver disease, as thrombosis seems to contribute to progression of liver disease, and inhibiting thrombosis seems a promising treatment strategy to prevent this.
The last part of my thesis, that was written during the coronavirus-19 (COVID-19) pandemic, focused on the contribution of the coagulation system on the progression and recovery of COVID-19. Although the link between COVID-19 and liver disease isn’t immediately obvious, I did find some similarities.