{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T21:50:13Z","timestamp":1775512213059,"version":"3.50.1"},"reference-count":58,"publisher":"Georg Thieme Verlag KG","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>Patienten mit Leberzirrhose weisen komplexe Ver\u00e4nderungen des h\u00e4mostatischen Systems auf, die sowohl mit Blutungs- als auch mit thrombotischen Komplikationen einhergehen k\u00f6nnen und im Rahmen des klinischen Managements ber\u00fccksichtigt werden sollten.<\/jats:p><jats:p>W\u00e4hrend eine prophylaktische Korrektur abnormaler Gerinnungsparameter vermieden werden sollte, ist vor invasiven Prozeduren ein individualisiertes Vorgehen zu empfehlen, wobei sich spezifische Pr\u00e4ventionsma\u00dfnahmen zur Stabilisierung der Gerinnung am periprozeduralen Blutungsrisiko orientieren sollten.<\/jats:p><jats:p>Weiterhin gilt zu beachten, dass sich die h\u00e4mostatischen Ver\u00e4nderungen in Abh\u00e4ngigkeit des Stadiums der Erkrankung unterscheiden. W\u00e4hrend sich das h\u00e4mostatische System bei kompensierter Zirrhose oftmals in einem Gleichgewicht befindet, kann das Auftreten einer akuten Dekompensation zu einer Destabilisierung dieses Zustands f\u00fchren.<\/jats:p><jats:p>Da konventionelle Gerinnungstests die komplexen Ver\u00e4nderungen des h\u00e4mostatischen Systems bei Zirrhose nicht ad\u00e4quat erfassen, k\u00f6nnen funktionelle Analysemethoden, wie viskoelastische Testverfahren oder Thrombingenerierungstests bei der Evaluation des Gerinnungsstatus hilfreich sein.<\/jats:p><jats:p>Die vorliegende \u00dcbersichtsarbeit beschreibt die zugrunde liegenden pathophysiologischen Ver\u00e4nderungen des h\u00e4mostatischen Systems bei Leberzirrhose, liefert einen \u00dcberblick \u00fcber geeignete Diagnostikmethoden und thematisiert Therapiema\u00dfnahmen im Falle von Blutungs- und thrombotischen Komplikationen.<\/jats:p>","DOI":"10.1055\/a-2330-3564","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T22:48:53Z","timestamp":1722638933000},"page":"963-973","source":"Crossref","is-referenced-by-count":1,"title":["Gerinnungsst\u00f6rungen bei Leberzirrhose \u2013 Diagnostik und Management"],"prefix":"10.1055","volume":"149","author":[{"given":"Philipp","family":"Kasper","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie und Hepatologie, Universit\u00e4tsklinikum K\u00f6ln, K\u00f6ln"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Tacke","sequence":"additional","affiliation":[{"name":"Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charit\u00e9 Campus Mitte und Campus Virchow-Klinikum, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Michels","sequence":"additional","affiliation":[{"name":"Notfallzentrum, Krankenhaus der Barmherzigen Br\u00fcder Trier, Medizincampus der Universit\u00e4tsmedizin Mainz, Trier, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1002\/rth2.12028","article-title":"Pathogenesis, prevention, and management of bleeding and thrombosis in patients with liver diseases","volume":"1","author":"T Lisman","year":"2017","journal-title":"Res Pract Thromb Haemost"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1016\/j.jhep.2021.11.004","article-title":"Haemostatic alterations and management of haemostasis in patients with cirrhosis","volume":"76","author":"T Lisman","year":"2022","journal-title":"J Hepatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1016\/j.jhep.2021.09.003","article-title":"EASL Clinical Practice Guidelines on prevention and management of bleeding and thrombosis in patients with cirrhosis","volume":"76","author":"European Association for the Study of the Liver. 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