The hemostatic balance in patients with liver disease as compared to that of healthy individuals. The cartoons depict the stable hemostatic balance in healthy individuals and show that although the hemostatic system in patients with liver disease is (re)balanced, the balance is fragile and may easily tip to either a hypo- or hypercoagulable status (reprinted with permission from Lisman T, Kamphuisen PW, Northup PG, Porte RJ: Established and new-generation antithrombotic drugs in patients with cirrhosis—Possibilities and caveats. J Hepatol 2013; 59:358–66). The bottom part of the figure depicts all pro- and antihemostatic changes in patients with liver disease and shows a rebalance of all major components of hemostasis.