Fibrinogen derivatives and platelet activation products in acute and chronic liver disease

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Abstract
The concentration in plasma of fibrinogen derivatives fibrinopeptide A (FPA) and B.beta.1-42 and the platelet release products .beta.-thromboglobulin (.beta.TG) and platelet factor 4 (PF4) were determined in patients with acute and chronic liver disease. In 21 patients with fulminant hepatic failure on admission in grade III or IV coma the plasma FPA, B.beta.1-42, .beta.TG and PF4 levels were significantly increased compared with those in normal control subjects. On heparinization before hemoperfusion the FPA levels returned to the normal range and during resin and charcoal hemoperfusion there were no significant changes in the coagulation of platelet factors, except for a small increase in FPA with charcoal hemoperfusion. In 10 patients with compensated chronic liver disease there was a significant increase in B.beta.1-42 and .beta.TG levels but not FPA and PF4 as compared with normal controls. Interpretation of the results is complicated by the possible reduced clearance of these proteins as a result of renal failure in some of the patients with fulminant hepatic failure and also by the damaged liver itself. Disseminated intravascular coagulation apparently can occure in both acute and chronic liver disease.