Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Angelo Andriulli, Armando Tripodi, Paolo Angeli, Marco Senzolo, Massimo Primignani, Edoardo G.B. Giannini, O. Riggio, A. Colli, D. Prati, David Sacerdoti, Carlo Merkel, Stefania Basili, D. Ferro, Erica Villa, G. Di Minno, P. Caraceni, Marco Marzioni, Pier Mannuccio Mannucci, Francesco Violi, Fabio PiscagliaVicenza Calvaruso, Lesley De Pietri, M. Falcone, Paolo Feltracco, Elvira Grandone, Vincenzo La Mura, Anna Licata, C. Lucidi, Sergio Maimone, M. Marietta, Filomena Morisco, Laura Napoleone, Salvatore Piano, Valeria Raparelli, Paolo Rebulla, Dario Ribero, M. T. Sartori, Antonella Scalera, Filippo Schepis, Massimo Sicilianom, Gianluca Svegliati Baroni, Antonella Tufano, Alessandro Vitale, Massimo Zuin

Research output: Contribution to journalArticlepeer-review


Patients with cirrhosis present with hemostatic alterations secondary to reduced availability of pro-coagulant and anti-coagulant factors. The net effect of these changes is a rebalanced hemostatic system. The Italian Association of the Study of the Liver (AISF) and the Italian Society of Internal Medicine (SIMI) promoted a consensus conference on the hemostatic balance in patients with cirrhosis. The consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Rome in December 2014. The statements were graded according to quality of evidence and strength of recommendations, and approved by an independent jury. The statements presented here highlight strengths and weaknesses of current laboratory tests to assess bleeding and thrombotic risk in cirrhotic patients, the pathophysiology of hemostatic perturbations in this condition, and outline the optimal management of bleeding and thrombosis in patients with liver cirrhosis.

Original languageEnglish
Pages (from-to)455-467
Number of pages13
JournalDigestive and Liver Disease
Issue number5
Publication statusPublished - May 1 2016


  • Bleeding
  • Cirrhosis
  • Hemostasis
  • Thrombosis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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