Table 1.

Alterations in the hemostatic system in patients with liver disease that impair (left) or promote (right) hemostasis

Changes that impair hemostasis	Changes that promote hemostasis
Thrombocytopenia	Elevated levels of von Willebrand Factor (VWF)
Platelet function defects	Decreased levels of ADAMTS‐13
Enhanced production of nitric oxide and prostacyclin	Elevated levels of factor VIII
Low levels of factors II, V, VII, IX, X, and XI	Decreased levels of protein C, protein S, antithrombin, α2‐macroglobulin, and heparin cofactor II
Vitamin K deficiency	Low levels of plasminogen
Dysfibrinogenemia
Low levels of α2‐antiplasmin, factor XIII, and TAFI
Elevated t‐PA levels

Source: Modified from the European Association for the Study of the Liver from Lisman et al.1 with permission.