Table 5.
Thresholds for coagulation parameters prior to high-risk procedures in patients with cirrhosis
|
Parameters
|
EASL 2022
|
ISTH 2021
|
AASLD 2021
|
AGA 2021
|
| PT/INR | Against routine evaluation and correction | Against correction | Against correction | Against routine evaluation and correctiona |
| Platelet count | Against correctionb | Against correctionb | Against correction | Against routine evaluation and correctiona |
| Fibrinogen | Against routine correction | Against routine evaluation | Against correction | No specific recommendation |
| TEG | Against routine evaluationc | Do not use routinely | Do not use routinely | No specific recommendation |
In case of severe coagulopathy, prophylactic blood transfusions should be considered on case-to-case basis by evaluating potential benefits and risks in consultation with a hematologist.
If the bleeding cannot be controlled by the local hemostasis method, administration of platelet concentrate or thrombopoietin receptor agonist can be considered if the platelet count is < 50000 × 106/L.
May provide a baseline coagulation status and guide in the case of bleeding events.
AASLD: American Association for the Study of Liver Diseases; AGA: American Gastroenterological Association; EASL: European Association for the Study of the Liver; INR: International normalized ratio; ISTH: International Society on Thrombosis and Hemostasis; PT: Prothrombin time; TEG: Thromboelastography.