Schematic presentation of the rebalanced hemostatic system in patients with liver disease. In healthy individuals (A), the hemostatic system is in solid balance. In patients with liver disease (B and table) both prohemostatic and antihemostatic changes result in a “rebalance” of the hemostatic system. This new balance is characterized by specific hypocoagulable and hypercoagulable features. ADAMTS13, a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13; PAI-1, plasminogen activator inhibitor-1; TAFI, thrombin activatable fibrinolysis inhibitor; tPA, tissue plasminogen activator; VWF, von Willebrand factor. Reprinted from van den Boom & Lisman with permission.⁴⁶