VWF/ADAMTS13 imbalance, but not global coagulation or fibrinolysis, is associated with outcome and bleeding in acute liver failure.

Rebalanced hemostatic status was confirmed in a large cohort of patients with ALI/ALF demonstrating that VWF/ADAMTS13 imbalance is associated with poor outcome and bleeding. The association between VWF/ADAMTS13 imbalance and bleeding suggest that bleeding in ALF relates more to systemic inflammation than a primary coagulopathy.