The fibrinolytic state in cirrhotic patients is still a debated subject. Historically, cirrhotic patients were thought to be in a hyperfibrinolytic state that was thought to contribute to bleeding risk. More recently, this hyperfibrinolytic state and its association with bleeding risk have been put into question. Patients with cirrhosis show simultaneous changes in profibrinolytic and antifibrinolytic mechanisms. Typically, a decrease in plasminogen, α2-antiplasmin, and thrombin activatable fibrinolysis inhibitor and an increase in tissue plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) are seen. [...]
van Dievoet, M.-A., Zouaoui Boudjeltia, K., Rousseaux, M., Douxfils, J., Lisman, T., & Stephenne, X. (2024). Fibrinolytic profile depends on disease severity in pediatric patients with cirrhosis: illustration by 2 different plasma-based fibrinolysis assays. Research and Practice in Thrombosis and Haemostasis, 8(6), 102551 [1-4]. https://doi.org/10.1016/j.rpth.2024.102551 (Original work published 2024)