{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:44:36Z","timestamp":1760244276078,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006595","name":"UEFISCDI","doi-asserted-by":"publisher","award":["PCE 80\/2022\/PN-III-P4-PCE-2021-0601 \u201dTEG-HANDLED\u201d","35146\/17.12.2021"],"award-info":[{"award-number":["PCE 80\/2022\/PN-III-P4-PCE-2021-0601 \u201dTEG-HANDLED\u201d","35146\/17.12.2021"]}],"id":[{"id":"10.13039\/501100006595","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UMFIH internal","award":["PCE 80\/2022\/PN-III-P4-PCE-2021-0601 \u201dTEG-HANDLED\u201d","35146\/17.12.2021"],"award-info":[{"award-number":["PCE 80\/2022\/PN-III-P4-PCE-2021-0601 \u201dTEG-HANDLED\u201d","35146\/17.12.2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Cirrhosis is associated with frequent alterations in standard coagulation tests that do not adequately reflect hemostasis. Thromboelastography provides a global assessment of coagulation and evaluates the functional status of clotting factors, fibrinogen, platelets, and fibrinolysis. The study aimed to assess whether liver disease severity leads to progressive alterations in the thromboelastography-based assessment of coagulation. (2) Methods: Consecutive patients with cirrhosis and abnormal standard coagulation tests (at least one of International Normalized Ratio &gt; 2, platelet count &lt; 50 \u00d7 103\/\u00b5L, fibrinogen &lt; 200 mg\/dL) were analyzed using native thromboelastography. (3) Results: A total of 106 patients were included, of whom 69 (65.1%) had a normal thromboelastography. While the standard coagulation tests were significantly worse in patients in the Child C group (n = 62, 58.5%) than in patients staged in Child A and B, no significant differences existed between any of the thromboelastography variables. Of the 50 patients (47.1%) with an International Normalized Ratio &gt; 2, only two patients (4%) had features of hypocoagulation, while 26% had features of hypercoagulability on thromboelastography. Patients with a platelet count &lt; 50 \u00d7 103\/\u00b5L had significantly lower platelet function as assessed by thromboelastography, yet only eight patients (20%) met the criteria for platelet transfusion. A thromboelastography-based transfusion protocol might lead to a 94.6% reduction in blood product transfusion indications in a simulation where the included patients would require interventional procedures. (4) Conclusion: Standard coagulation tests showed a poor correlation with thromboelastography. Based on thromboelastography, patients with severe, decompensated liver disease have a preserved hemostasis balance despite abnormal standard coagulation tests. Therefore, standard coagulation tests should not be used to guide the administration of blood products in patients with cirrhosis.<\/jats:p>","DOI":"10.3390\/jcm13216614","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T10:57:20Z","timestamp":1730717840000},"page":"6614","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cirrhosis Progression Is Not Associated with Clinically Significant Alterations in Global Hemostasis Assessed by Thromboelastography"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5872-8630","authenticated-orcid":false,"given":"Rare\u0219","family":"Cr\u0103ciun","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Gastroenterology Clinic, \u201cProf. Dr. O. Fodor\u201d Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alina","family":"Buliarc\u0103","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3362-4368","authenticated-orcid":false,"given":"Daniela","family":"Matei","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Gastroenterology Clinic, \u201cProf. Dr. O. Fodor\u201d Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiana","family":"Grap\u0103","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Gastroenterology Clinic, \u201cProf. Dr. O. Fodor\u201d Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iuliana","family":"Nenu","sequence":"additional","affiliation":[{"name":"Department of Physiology, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-5471","authenticated-orcid":false,"given":"Horia","family":"\u0218tef\u0103nescu","sequence":"additional","affiliation":[{"name":"Gastroenterology Clinic, \u201cProf. Dr. O. Fodor\u201d Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tudor","family":"Mocan","sequence":"additional","affiliation":[{"name":"Gastroenterology Clinic, \u201cProf. Dr. O. Fodor\u201d Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"},{"name":"UBBMed Department, Babe\u0219-Bolyai University, 400084 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bogdan","family":"Procope\u021b","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Gastroenterology Clinic, \u201cProf. Dr. O. Fodor\u201d Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeno","family":"Sp\u00e2rchez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"},{"name":"Gastroenterology Clinic, \u201cProf. Dr. O. Fodor\u201d Regional Institute of Gastroenterology and Hepatology, 400162 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1053\/j.gastro.2019.03.070","article-title":"AGA Clinical Practice Update: Coagulation in Cirrhosis","volume":"157","author":"Greenberg","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.1053\/j.gastro.2021.09.004","article-title":"AGA Technical Review on Coagulation in Cirrhosis","volume":"161","author":"Intagliata","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_3","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":"Lisman","year":"2010","journal-title":"Blood"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1056\/NEJMra1011170","article-title":"The Coagulopathy of Chronic Liver Disease","volume":"365","author":"Tripodi","year":"2011","journal-title":"N. 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Hepatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/21\/6614\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:28:07Z","timestamp":1760113687000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/21\/6614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,4]]},"references-count":33,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["jcm13216614"],"URL":"https:\/\/doi.org\/10.3390\/jcm13216614","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2024,11,4]]}}}