{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:41:47Z","timestamp":1781073707816,"version":"3.54.1"},"reference-count":73,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic liver disease is a frequently encountered disorder and a major concern worldwide with a complex pathophysiology, which often affects the hemostatic system. Such alterations, which affect both primary and secondary hemostasis, are heterogenous, including prohemorrhagic (i.e., decreased coagulation factors, increased fibrinolysis, thrombocytopenia, and platelet dysfunction) and prothrombotic (i.e., decreased natural anticoagulants) changes. As a consequence of this unstable balance, patients with liver cirrhosis may experience both hemorrhagic complications and venous thromboembolic events, which are often unpredictable and whose management is particularly challenging for clinicians. This narrative review will address the most recent advances in the pathophysiology of key derangements of hemostasis in patients with chronic liver disease, focusing on their clinical implications and management.<\/jats:p>","DOI":"10.1055\/a-2531-4712","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T19:10:26Z","timestamp":1738696226000},"page":"335-341","source":"Crossref","is-referenced-by-count":4,"title":["Coagulation Abnormalities in Chronic Liver Disease"],"prefix":"10.1055","volume":"52","author":[{"given":"Massimo","family":"Franchini","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Mannuccio","family":"Mannucci","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico and University of Milan, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"782","DOI":"10.23736\/S0375-9393.19.13468-2","article-title":"Perioperative hemostatic management in the cirrhotic patient: a position paper on behalf of the Liver Intensive Care Group of Europe (LICAGE)","volume":"85","author":"G Biancofiore","year":"2019","journal-title":"Minerva Anestesiol"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/ejh.13688","article-title":"The hemostatic and thrombotic complications of liver disease","volume":"107","author":"H S McMurry","year":"2021","journal-title":"Eur J Haematol"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1056\/NEJMra1011170","article-title":"The coagulopathy of chronic liver disease","volume":"365","author":"A Tripodi","year":"2011","journal-title":"N Engl J Med"},{"issue":"01","key":"ref4","first-page":"32","article-title":"Liver disease, coagulopathies and transfusion therapy","volume":"11","author":"P M Mannucci","year":"2013","journal-title":"Blood Transfus"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1182\/blood-2010-02-261891","article-title":"Rebalanced hemostasis in patients with liver disease: evidence and clinical consequences","volume":"116","author":"T Lisman","year":"2010","journal-title":"Blood"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1038\/ajg.2016.498","article-title":"Changing concepts of cirrhotic coagulopathy","volume":"112","author":"A Tripodi","year":"2017","journal-title":"Am J Gastroenterol"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s11739-009-0302-z","article-title":"Abnormalities of hemostasis and bleeding in chronic liver disease: the paradigm is challenged","volume":"5","author":"A Tripodi","year":"2010","journal-title":"Intern Emerg Med"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/j.jhep.2011.06.008","article-title":"Patients with liver cirrhosis suffer from primary haemostatic defects? 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