ArticleJournal of thrombosis and haemostasis : JTH2021
Prophylactic fresh frozen plasma and platelet transfusion have a prothrombotic effect in patients with liver disease.
Article in Journal of thrombosis and haemostasis : JTH, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- [Concise guidelines for the clinical management of thrombocytopenia in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Guideline
- Plasma-based strategies for systemic rejuvenation: critical perspectives on clinical translation.GeroScience · 2026Review
- Effect of prophylactic platelet transfusion on bleeding risk in patients with cirrhosis and thrombocytopenia undergoing ultrasound-guided liver biopsy.Ultrasonography (Seoul, Korea) · 2026Article
- Chinese Expert Consensus for the Management of Thrombocytopenia in Cirrhosis.Journal of clinical and translational hepatology · 2025Article
- Prediction and prevention of post-procedural bleedings in patients with cirrhosis.Clinical and molecular hepatology · 2025Review
- Outcomes of Outpatient Elective Esophageal Varices Band Ligation in Cirrhosis Patients with Significant Thrombocytopenia.Diseases (Basel, Switzerland) · 2025Article
- Hemostatic conditions following autologous transfusion of fresh vs stored platelets in experimental endotoxemia: an open-label randomized controlled trial with healthy volunteers.Research and practice in thrombosis and haemostasis · 2024Article
- [Clinical management of thrombocytopenia in cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2024Review
- Efficacy of fresh frozen plasma transfusion in decompensated cirrhosis patients with coagulopathy admitted to ICU: a retrospective cohort study from MIMIC-IV database.Scientific reports · 2024Article
- How to manage hemostasis in patients with liver disease during interventions.Hematology. American Society of Hematology. Education Program · 2023Review
- Bleeding and Thrombosis in Patients With Cirrhosis: What's New?HemaSphere · 2023Article
- Indications for the Use of Therapeutic Plasma in Adult Patients.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2023Review
- Thrombocytopenia and liver disease: pathophysiology and periprocedural management.Hematology. American Society of Hematology. Education Program · 2022Article
- Pathophysiology and management of bleeding and thrombosis in patients with liver disease.International journal of laboratory hematology · 2022Review
- Effect of thrombocytopenia and platelet transfusion on outcomes of acute variceal bleeding in patients with chronic liver disease.World journal of hepatology · 2022Article
- Global hemostatic profiling in patients with decompensated cirrhosis and bacterial infections.JHEP reports : innovation in hepatology · 2022Article
- Prophylactic fresh frozen plasma versus prothrombin complex concentrate for preprocedural management of the coagulopathy of liver disease: A systematic review.Research and practice in thrombosis and haemostasis · 2022Article
- Dualistic role of platelets in living donor liver transplantation: Are they harmful?World journal of gastroenterology · 2022Review
- Fibrin clot quality in acutely ill cirrhosis patients: Relation with outcome and improvement with coagulation factor concentrates.Liver international : official journal of the International Association for the Study of the Liver · 2022Article
- Platelet Transfusion in Patients With Sepsis and Thrombocytopenia: A Propensity Score-Matched Analysis Using a Large ICU Database.Frontiers in medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsPatients with liver disease acquire complex changes in their hemostatic system, resulting in prolongation of the international normalized ratio and thrombocytopenia. Abnormalities in these tests are commonly corrected with fresh frozen plasma (FFP) or platelet transfusions before invasive procedures. Whether these prophylactic transfusions are beneficial and truly indicated is increasingly debated. In this study, we studied ex vivo effects of FFP and platelet transfusions in patients with liver disease-associated hemostatic changes in a real-life clinical setting.
methodsWe included 19 patients who were deemed to require prophylactic FFP transfusion by their treating physician and 13 that were prescribed platelet transfusion before a procedure. Hemostatic status was assessed in blood samples taken before and after transfusion and compared with healthy controls (n = 20).
resultsEx vivo thrombin generation was preserved in patients with liver disease before FFP transfusion. Following FFP transfusion, both in and ex vivo thrombin generation significantly increased, as evidenced by a 92% and 38% increase in thrombin-antithrombin and prothrombin fragment 1 + 2 levels, respectively, and a 20% increase in endogenous thrombin potential. Platelet counts increased from 28 [21-41] × 10
conclusionsFFP and platelet transfusion resulted in increased thrombin generation and platelet counts in patients with liver disease, indicating a prothrombotic effect. However, whether all transfusions were truly indicated and had a clinically relevant effect is questionable.
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