Correlation Between Thrombin Generation and Hepatic Fibrosis in Chronic Liver Diseases

Hepatic stellate cells (HSC) are recruited to the site of injury in the liver tissue repair mechanism, and the changes HSC undergo reflect paracrine stimulation by all cell types (sinusoidal endothelial cells, Kupffer cells, hepatocytes, platelets, and leukocytes). This study aimed to analyse a possible correlation between the degree of liver fibrosis and thrombin generation in patients with chronic liver diseases. Background Coagulation disorders in patients with chronic liver disease continue to challenge clinicians. A more accurate assessment of the coagulation cascade is provided by investigating thrombin production in individuals with chronic liver disease with varying degrees of fibrosis. Methods This prospective observational pilot study was done on hospitalized patients with chronic liver diseases. Thrombin generation from their platelet-poor plasma was studied and the degree of liver fibrosis assessed by transient elastography versus that of control subjects. Results The peak thrombin is significantly higher in those with severe liver stiffness (F3) than in those with more advanced fibrosis/liver cirrhosis (F4). Also, the total concentration of thrombin formed in the time interval (area under the curve (AUC)) and velocity index (VI) is higher in those with F3 than those with F4. Conclusion Thrombin generation decreases with the progression of liver fibrosis.