Which factor is NOT affected by liver disease?

The ability of the liver to produce clotting factors is a crucial aspect of its function, and liver disease significantly impacts many of these factors. However, Factor VIII is primarily produced by endothelial cells, not the liver. This means that its levels can remain relatively stable even in the presence of liver dysfunction, which often affects factors synthesized directly by the liver.

In contrast, Factors II (prothrombin), I (fibrinogen), and V are all synthesized in the liver. In liver disease, the production of these factors is compromised, leading to coagulopathy. The liver's role in the synthesis of clotting factors emphasizes how liver disease can significantly impair hemostatic balance, except for Factor VIII, which is notably less affected because of its alternate production site.

Understanding the production locations of these factors highlights why liver disease predominantly impacts those synthesized in the liver while sparing others like Factor VIII.