Chronic liver disease is characterized by a global hemostatic defect that includes platelet-vessel wall interaction (primary hemostasis), fibrinolysis and coagulation causing abnormalities of the relevant laboratory tests. The causal relationship between abnormal tests and bleeding has been widely accepted, despite the fact that abnormal tests are poorly associated with bleeding. Recent evidence from the literature disputes the above paradigm and open new directions for laboratory and clinical research in this field.
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