**9. Conclusions**

**7.4. Liver disorders**

144 Hematology - Latest Research and Clinical Advances

liver disorders.

**8. Diagnosis of coagulation disorders**

commonly used assays were discussed here.

**8.1. Prothrombin time assay (PT assay)**

enhanced chances of thrombosis [135].

**8.3. Clot waveform analysis (CWA)**

**8.4. Coagulation markers**

**8.2. Activated prothrombin time assay (aPTT assay)**

ening of the aPTT indicates risk of thrombosis [136].

X, IX, VII, V and II levels in the plasma [137, 138].

Liver is the major source of coagulation factors. Chronic alcoholism, smoking and high fat consumption affect the function of liver and there by impact the synthesis of coagulation factors [134]. Blood transfusion is recommended for treating the coagulation defects caused by

Coagulation defects are measured by the general assays such as aPTT and PT assays, direct measurement of antigen levels and specific coagulation factor activity assays. Some of the

PT assay is used to measure the functional integrity of extrinsic pathway. Clotting is initiated by supplementing tissue factor and calcium chloride to the platelet poor plasma. Elongation of PT indicates the increase in bleeding disorders, similarly shortening of PT indicates the

aPTT assay is used to measure the integrity of intrinsic pathway. In this method the clotting is initiated by supplementing Kontact reagent and calcium chloride to the platelet poor plasma. Similar to PT assay, prolongation of aPTT indicates the risk of bleeding disorders and short-

CWA is a modified form of aPTT assay, where the light absorbance of the clot measured from the clot initiation to the lysis of the clot and the absorbance is plotted with respect to time using first and second derivates. This assay is more sensitive to measure the changes in FXII,

The coagulation activation and fibrinolysis markers are measured to determine the defects in the coagulation system. One of the diagnostic method to estimate the risk of thrombosis is measuring the D-Dimer antigen levels in the plasma. D-Dimers are the degradation products of cross linked fibrinogen generated during fibrinolysis, increase in the plasma D-Dimer antigen levels directly corresponds to an increase in the risk of thrombosis [139]. Prothrombin fragment 1 + 2 (F1 + 2) are the cleavage products generated from prothrombin and F1 + 2 levels are measured to diagnose the risk of thrombosis, sepsis and DIC [140]. Free thrombin that moves away from the site of clot formation forms a complex with antithrombin III and the Coagulation is a complicated biological phenomenon which maintains the hemostasis. Abnormalities in the genes that regulate the coagulation factors cause hereditary coagulation defects such as hemophilia and mutations in genes that encode anticoagulants such as Protein S, Protein Z cause thrombosis. Disruption in the anticoagulant and coagulation factors in the healthy individual causes acquired bleeding disorders. Acquired bleeding disorders include a bleeding disorder or a thrombotic disorder. These disorders can be diagnosed by current methods and can be treated with known methods. There is a high demand for efficient diagnostic and treatment methods for the abnormalities in the coagulation disorders.
