ABSTRACT
This chapter discusses the role of the liver in fibrinolysis, changes in fibrinolysis in cirrhosis, and the management of disorders of fibrinolysis in patients with liver cirrhosis. Liver disease is frequently complicated by clinically significant bleeding. The incidence of bleeding has been estimated to be 32% in patients with cirrhosis of the liver and is sometimes life-threatening. Cirrhosis is the most common chronic disease of the liver. Fibrinolytic activity was measured by a quantitative technique in which plasma was clotted by the addition of thrombin, fibrin levels were measured before and after 6, 12, and 24 h incubation at 37°C. The decreased hepatic clearance of plasminogen activators in cirrhosis as the pathogenetic mechanism of hyperfibrinolysis was suggested originally by A. Fletcher. Because plasminogen is the precursor of plasmin, its availability is of major importance for normal functioning of the fibrinolytic system.
