Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Alves, A.
Effects of Liver Surgery on Vascular Health
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2021. pp. 97
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Goswami Nandu
- Waha James Elvis
- Altmetrics:
- Abstract:
- Introduction: Liver diseases are common in today’s society. The main reasons for liver surgery are benign and malignant lesions, with some disease stages even requiring liver transplantation. The liver is the most important organ in terms of synthesis and clearance of proteins responsible for hemostasis. With impaired liver function and loss of parenchyma after liver resection, hemostasis is assumingly affected. Disturbances in hemostasis affect vascular health by either promoting bleeding or blood clotting. Thrombosis and thromboembolism can lead to vascular occlusion and following vascular and organ dysfunction. Vascular occlusion which leads to ischemic heart disease and stroke, the two leading causes of death worldwide, is in most cases caused by thrombi due to ruptured atherosclerotic plaques or by thromboembolism. Identifying the effects of liver surgery on hemostasis is crucial for determining adequate treatment and ensuring vascular health. Aims and objectives: The aim of this thesis is to present an overview of recent study results on the effects of hepatectomy on hemostasis, as one aspect of liver surgery affecting vascular health. Methodology: A systemic research of the currently published literature on the effects of hepatectomy on hemostasis was conducted. Search engines used were PubMed and Web of Science. Access to most publications was given through the Medical University of Graz. Studies published in 2015 and following years, in which parameters of hemostasis or fibrinolysis were measured perioperative to hepatectomy were considered. Relevant studies were further grouped into curative hepatectomy in liver disease and hepatectomy for living organ donation. Results: The literature research resulted in over 2862 publications, of which 15 publications met all inclusion criteria. Discussion: Following liver resection, measurements suggested different states of hemostasis. While thrombin generation assay and viscoelastic tests identified either normal hemostasis or a transient hypercoagulable state, conventional coagulation parameters suggested a hypocoagulable state. With viscoelastic tests providing a more realistic picture of hemostasis in vivo, and in addition to individual hemostatic parameter levels measured perioperatively, curative hepatectomy was shown to promote a potentially prothrombotic state. Therefore, vascular health is affected by liver surgery in terms of an increased risk for thromboembolism.