Trastornos de la coagulación en cirrosis hepática: artículo de revisión

Autores/as

DOI:

https://doi.org/10.52784/27112330.145

Palabras clave:

cirrosis hepática, coagulopatía, tromboelastografía, hemorragia, trombosis, procoagulante, anticoagulantes.

Resumen

Los eventos fisiopatológicos de la cirrosis hepática alteran drásticamente los procesos de hemostasia primaria, secundaria y fibrinólisis. Antiguamente se conceptuaba que dichas alteraciones predisponían exclusivamente a un estado de hipocoagulabilidad, debido a la baja producción hepática de factores procoagulantes y a la trombocitopenia característica. Actualmente existe evidencia de mecanismos de compensación que llevan a un reequilibrio hemostático, que es inestable y fácilmente desregulado ante comorbilidades, complicaciones y progresión de la enfermedad, conduciendo a fenómenos prohemorrágicos o protrombóticos, como trombosis venosa portal, tromboembolismo venoso, etc. Para determinar eficazmente si un paciente cirrótico tiene riesgo de sangrado, no son de utilidad las pruebas de coagulación convencionales. El tratamiento dependerá del estado hipo o hipercoagulable del paciente. Para ello desarrollamos una revisión de los fenómenos hemostáticos en la cirrosis, con el fin de dar a conocer sus características, el método de diagnóstico más eficaz y los tratamientos disponibles.

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Biografía del autor/a

Esteban González-Domínguez, Hospital Santa Inés, Universidad de Cuenca

Médico, Especialista en Gastroenterología, Hepatología y Trasplante Hepático, PhD en Gastroenterología, Hospital Santa Inés. Profesor, Facultad de Medicina, Universidad de Cuenca. Cuenca, Ecuador.

Diego Córdova, Universidad de Cuenca

Médico General, Universidad de Cuenca. Cuenca, Ecuador.

Paula Abad, Universidad de Cuenca

Médica General, Universidad de Cuenca. Cuenca, Ecuador.

Eduardo González, Hospital São Francisco de Assis

Médico, Especialista en Cirugía General, Hospital São Francisco de Assis. Belo Horizonte, Brasil.

Camila González, Universidad de Cuenca

Médica General, Universidad de Cuenca. Cuenca, Ecuador

Juan José Cordero, Universidad de Cuenca

Estudiante de Medicina, Universidad de Cuenca. Cuenca, Ecuador.

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Publicado

2022-01-20

Cómo citar

González-Domínguez, E., Córdova, D., Abad, P., González, E., González, C., & Cordero, J. J. (2022). Trastornos de la coagulación en cirrosis hepática: artículo de revisión. Hepatología, 3(1), 13–28. Recuperado a partir de https://revistahepatologia.com/index.php/hepa/article/view/46

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