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. 2021 Mar 31;19(4):1116–1122. doi: 10.1111/jth.15239

FIGURE 1.

FIGURE 1

Hemostatic balance in patients with liver disease. Concomitant changes in both pro‐ and anti‐hemostatic pathways result in a ‘rebalanced’ hemostatic state in patients with liver disease. Panel A shows the hemostatic balance in healthy individuals, panel B shows the hemostatic balance in patients with liver disease together with the individual changes in the hemostatic system. The new hemostatic balance in patients with liver disease is much less stable compared to the balance in healthy individuals, as there is much less weight on each end of the hemostatic scale. Simultaneous changes promoting bleeding and promoting thrombosis occur in primary and secondary hemostasis, and fibrinolysis. Modified from Curr Opin Organ Transplant 2008; 13: 298–9 with permission from Wolters Kluwer Health. ADAMTS‐13, A Disintegrin And Metalloprotease with ThromboSpondin‐1 domain; APTT, activated partial thromboplastin time; FVIII, factor VIII; PT, prothrombin time; VWF, von Willebrand factor