Perioperative thromboprophylaxis in liver transplant patients

Table 1 Balance of antihemostatic and prohemostatic drivers in the cirrhotic patient

	Anti-hemostatic drivers	Pro-hemostatic drivers
Primary hemostasis	Abnormal platelet function	Elevated vWF
	Thrombocytopenia	Reduced ADAMTS 13
	Decreased production of thrombopoietin	Platelet hyperreactivity
Coagulation	Reduced synthesis of factors II, V, VII, IX, X, and XI	Elevated factor VIII
	Vitamin K deficiency	Reduced anticoagulant protein C, protein S, antithrombin III
	Hypo-dysfibrinogenemia	Procoagulant changes in fibrin structure
Fibrinolysis	Low α2-antiplasmin,	Low plasminogen
	factor XIII, and TAFI	High PAI
	Elevated tPA

vWF: Von Willebrand factor; TAFI: Thrombin-activatable fibrinolysis inhibitor; t-PA: Tissue plasminogen activator; PAI: Plasminogen activator inhibitor; ADAMTS13: A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13.