Why (and how) does coagulopathy occur with liver disease? — Part 1

Patients with end-stage liver disease have elevated INRs. They bleed frequently and they clot perhaps more frequently. Do they need FFP before a paracentesis? What’s a TEG? These questions answered, and more, in our multi-part series on the coagulopathy of liver disease!

The rise and fall of bilirubin and alkaline phosphatase

Why, after an episode of prolonged biliary obstruction, or after severe forms of acute liver injury, does the alkaline phosphatase (ALP) rise in a delayed fashion? And why do the ALP and total bilirubin often take a while to normalize? We’ve all heard (or said) this before. Today, let’s get to the bottom of why this happens!