Pathway of Coagulation

Tujuan utama koagulasi : merubah fibrinogen menjadi

fibrin.
Fibrin : sticky protein, seperti jaring laba-laba. Akn
menangkap trombosit dan eritrosit.akhirnya terbentuk
massa fibrin di daerah vasa yang injury
Faktor koagulasi umumnya beredar di sirkulasi darah
dalam bentuk inaktivasi.
Saat 1 faktor teraktivasi, faktor sesuai pathway
berikutnya akan teraktivasi.
Saat terjadi aktivasi faktor koagulasi, akan terjadi reaksi
cascade reaksi sambung-menyambung.
Saat vessel ruptur, fibrinogen akan terekspos ke aliran
darah. Hal ini akan membuat trombosit menempel ke
bagian itu, akan terbentuk platelet plug, hasilnya bisa
menurunkan perdarahan minor.
Setelah menempel, akan terjadi proses degranulasi
trombosit, dan mengeluarkan faktor XII, dan mekanisme
intrinsik dimulai.
Saat vasa ruptur, akan mengeluarkan faktor III, dan
mekanisme ekstrinsik dimulai.
Mekanisme intrinsik : faktor koagulasi bersal dari sel darah
itu sendiri.
Mekanisme ekstrinsik : faktor koagulasi diluar sel darah itu
sendiri.
Once factor X is activated, the remaining events are
identical in the intrinsic and extrinsic mechanisms.
Factor X combines with factors III and V in the presence
of Ca2 and PF3 to produce prothrombin activator. This
enzyme acts on a globulin called prothrombin (factor
II) and converts it to the enzyme thrombin. Thrombin
then chops up fibrinogen into shorter strands of fibrin.
Factor XIII crosslinks these fibrin strands to create a
dense aggregation called fibrin polymer, which forms
the structural framework of the blood clot.
Once a clot begins to form, it launches a self-
accelerating positive feedback process that seals off
the damaged vessel more quickly. Thrombin works
with factor V to accelerate the production of
prothrombin activator, which in turn produces more
thrombin

Liver disease and blood clotting
Proper blood clotting depends on normal liver function for
two reasons. First, the liver synthesizes most of the clotting
factors. Therefore, diseases such as hepatitis, cirrhosis, and
cancer that degrade liver function result in a deficiency of
clotting factors. Second, the synthesis of clotting factors II,
VII, IX, and X require vitamin K. The absorption of vitamin K
from the diet requires bile, a liver secretion. Gallstones can
lead to a clotting deficiency by obstructing the bile duct
and thus interfering with bile secretion and vitamin K
absorption. Efficient blood clotting is especially important
in childbirth, since both the mother and infant bleed from
the trauma of birth. Therefore, pregnant women should
take vitamin K supplements to ensure fast clotting, and
newborn infants may be given vitamin K injections