Hemostasis and the diseased liver : a study on hemostatic disorders in liver disease and liver transplantation

In this thesis studies on hemostatic disorders in liver cirrhosis and liver transplantation have been described. Aims of the work were to further investigate; 1. Whether (low-grade) DIC occurs in liver cirrhosis applying new quantitative tests, measuring thrombin-antithrombin Ill complex, soluble fibrin and dDimer. 2. The mechanism underlying increased fibrinolysis during OLT by ccmparing fibrinolytic activity in OLT, HLT and PHR. 3. The mechanism underlying the coagulation changes in liver transplantation and whether they are associated with DIC, by measuring thrombinantithrombin- Ill complex and conventional DIC parameters during orthotopic and heterotopic liver transplantation and partial hepatic resections. 4. The effects of different long-term graft preservation on hemostasis during porcine orthotopic and heterotopic liver transplantations and whether HLT protects the recipient from the effects of long-term preserved grafts on hemostasis. 5. To determine the origin of the heparin(-like) effect observed after reperfusion of the liver graft. (Whether heparin, given to the donor shortly before the hepatectomy, can be retrieved in the recipient after graft reperfusion.) 6. Whether there is a difference between OLT and HLT regarding postoperative hemostatic recovery and whether there is a contribution from the host liver in postoperative synthesis of hemostasis factors.

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