ArticleJournal of thrombosis and haemostasis : JTH2021
Treatment of bleeding 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 17 papers.
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Who cites it
17 citing papers in PubMed, 38 citations in OpenAlex.
- [Acute management of bleeding complications and coagulation disorders in critically ill patients with liver cirrhosis].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- [Pathophysiological mechanisms of coagulation dysfunction associated with liver disease].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- Risk of intracranial hemorrhage in critically ill ACLF patients: a retrospective single center cohort study.BMC gastroenterology · 2026Article
- Hemostasis in Liver Disease Within Patient Blood Management: A Scoping Review of the Current Literature.Journal of clinical medicine · 2026Review
- Coagulation Abnormalities in Liver Cirrhosis: Diagnostic and Therapeutic Approaches.Medicina (Kaunas, Lithuania) · 2026Review
- EASL postgraduate course report: Vascular biology in chronic liver disease and clinical management implications.JHEP reports : innovation in hepatology · 2025Review
- Role of Coagulation Factors in Hepatocellular Carcinoma: A Literature Review.Life (Basel, Switzerland) · 2024Review
- Article
- The Bleeding Edge: Managing Coagulation and Bleeding Risk in Patients with Cirrhosis Undergoing Interventional Procedures.Diagnostics (Basel, Switzerland) · 2024Review
- Article
- Novel horizons in anticoagulation: the emerging role of factor XI inhibitors across different settings.Haematologica · 2024Review
- Bleeding recurrence risk among hospitalized patients undergoing therapeutic plasma exchange: a multi-center study.Blood transfusion = Trasfusione del sangue · 2024Article
- Direct oral anticoagulants in cirrhosis: Rationale and current evidence.JHEP reports : innovation in hepatology · 2024Review
- Trends in prescribing and outcomes in obese versus non-obese patients receiving rivaroxaban therapy: an observational study using real-world data.European journal of clinical pharmacology · 2023Observational
- Bleeding and Thrombosis in Patients With Cirrhosis: What's New?HemaSphere · 2023Article
- Coming soon to a pharmacy near you? FXI and FXII inhibitors to prevent or treat thromboembolism.Hematology. American Society of Hematology. Education Program · 2022Article
- Blood products and liver transplantation: A strategy to balance optimal preparation with effective blood stewardship.Transfusion · 2022Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients with cirrhosis frequently have complex alterations in their hemostatic system. Although routine diagnostic tests of hemostasis in cirrhosis (platelet count, prothrombin time, fibrinogen level) are suggestive of a bleeding tendency, it is now widely accepted that these tests do not reflect hemostatic competence in this population. Rather, patients with cirrhosis appear to have a rebalanced hemostatic system with hypercoagulable elements. Therefore, routine correction of hemostasis laboratory values, for example by fresh frozen plasma or platelet concentrates, with the aim to avoid spontaneous or procedure-related bleeding is not indicated as is outlined in recent clinical guidance documents. However, little guidance on how to manage patients with cirrhosis that are actively bleeding is available. Here we present three common bleeding scenarios, variceal bleeding, post-procedural bleeding and bleeding in a critically ill cirrhosis patient, with specific management suggestions. As patients with cirrhosis generally have adequate hemostatic competence and as bleeding complications may be unrelated to hemostatic failure, prohemostatic therapy is not the first line of management in bleeding patients with cirrhosis, even in the presence of markedly abnormal platelet counts and/or prothrombin times. We provide a rationale for the restrictive approach to prohemostatic therapy in bleeding patients with cirrhosis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.