The liver is the site of production for most of our clotting factors. Therefore, impaired liver function could adversely affect these hemostatic proteins.
Indicators of a potential liver problem include:
- A decrease in the vitamin K-dependent factors, starting with factor VII, followed by reductions in factor II and X levels. Factor V levels are decreased in both acute and chronic liver disease, while factor IX levels are typically slightly reduced until advanced stages of liver disease.
- An increase in factor VIII. When the liver is damaged, the sinusoidal endothelial cells produce more factor VIII.
- The PT is sensitive to liver function, so an unexpected, prolonged PT should be evaluated.
- A lack of fibrinogen is often indicative of severe liver disease.
- Treating liver disease is difficult, so therapy typically centers around replacing the missing factors by administering fresh frozen plasma.
