EM1802G "“The Coagulopathy of Liver Disease: Fair and Rebalanced?” (IM-GR020918)

To introduce the concept of rebalanced hemostasis in chronic liver disease with implications for management of clinical bleeding and thrombosis.

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Target Audience

UT Southwestern faculty, fellows, residents and medical students, community physicians, nurse clinicians, physician assistants and nurses.

Learning Objectives

At the conclusion of this activity, the participant should be able to:

  • To understand that hemostasis in liver disease is rebalanced due to changes in procoagulant, anticoagulant and fibrinolytic systems.
  • To appreciate that current laboratory tests have limitations for evaluating the coagulopathy of liver disease. Specifically, the PT/INR measures only procoagulant factors and is a poor predictor of bleeding risk.
  • To understand why fresh frozen plasma is usually ineffective and why its use should be minimized.
  • To identify modifiable triggers of active bleeding in liver disease: portal hypertension, local vascular factors, renal failure, bacterial infection, and occasionally, vitamin K deficiency and low fibrinogen.
  • To recognize the increased risk of thrombosis in chronic liver disease and select candidates for anticoagulation for secondary prevention of thrombosis.
Course summary
Available credit: 
  • 1.00 AMA
Course opens: 
Course expires: 

Sandra Hofmann, M.D., Ph.D.
Professor of Internal Medicine & Molecular Genetics
Division of Hematology / Oncology

Dr. Hofmann is a Professor of Internal Medicine and Molecular Genetics in the Division of Hematology-Oncology. Her research interest is the post-translational modification of proteins by fatty acids and a lysosomal storage disorder caused by deficiency of palmitoyl-protein thioesterase, an enzyme discovered in her laboratory. Honors include the Jacob K. Javits Neuroscience Investigator (MERIT) Award, induction into the American Society for Clinical Investigation and Association of American Physicians and as a Fellow of the American Association for the Advancement of Science. In 2014 she received the Avanti Award in Lipids of the American Society for Biochemistry and Molecular Biology in recognition of her work on infantile Batten disease. She currently serves as attending physician on the hematology consult service at Parkland. Her clinical interests concern all aspects of benign hematology.

Available Credit

  • 1.00 AMA


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