Clinical considerations of coagulopathy in acute liver failure

Ahyoung Kim, Bolin Niu, Tinsay Woreta, Po Hung Chen

Research output: Contribution to journalArticlepeer-review


Acute liver failure (ALF) is the rapid onset of severe liver dysfunction, defined by the presence of hepatic encephalop-athy and impaired synthetic function (international normalized ratio of ≥1.5) in the absence of underlying liver disease. The elevated international normalized ratio value in ALF is often misinterpreted as an increased hemorrhagic tendency, which can lead to inappropriate, prophylactic transfusions of blood products. However, global assessments of coagulop-athy via viscoelastic tests or thrombin generation assay suggest a reestablished hemostatic, or even hypercoagu-lable, status in patients with ALF. Although the current versions of global assays are not perfect, they can provide more nuanced insights into the hemostatic system in ALF than the conventional measures of coagulopathy. Citation of this article: Kim A, Niu B, Woreta T, Chen PH. Clinical considerations of coagulopathy in acute liver failure.

Original languageEnglish (US)
Pages (from-to)407-413
Number of pages7
JournalJournal of Clinical and Translational Hepatology
Issue number4
StatePublished - 2020


  • Acute liver failure
  • Coagulopathy
  • Thrombin generation assay
  • Viscoelastic test

ASJC Scopus subject areas

  • Hepatology


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