ReviewHepatology international2025
Advances in the prevention and management of procedural bleeding in patients with cirrhosis.
Review in Hepatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guidelines for Minimizing Bleeding Risk During Bronchoscopic Procedures.Advances in respiratory medicine · 2026Guideline
- Effect of prophylactic platelet transfusion on bleeding risk in patients with cirrhosis and thrombocytopenia undergoing ultrasound-guided liver biopsy.Ultrasonography (Seoul, Korea) · 2026Article
- Acute Changes in Liver and Spleen Stiffness Following Endoscopic Variceal Ligation in Advanced Liver Disease-A Pilot Study.Journal of clinical medicine · 2026Article
- Clinical and pathophysiological perspectives on haemostasis, inflammation, and thrombo-haemorrhagic risk in cirrhosis.EXCLI journal · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPatients with cirrhosis frequently require procedures and are at risk of bleeding related to interventions. Procedural bleeding adversely impacts patients with cirrhosis and is associated with mortality. Assessment of bleeding risk in these patients is complex due to changes in hemostasis, portal hypertension, elevated thrombosis risk, and comorbid infection and renal disease. This clinical review will discuss current data regarding risk assessment, prevention, and management of procedural bleeding in patients with cirrhosis. DISCUSSION: Risk of procedural bleeding in patients with cirrhosis involves patient-related and procedure-related factors. Conventional hemostasis parameters such as prothrombin time and platelet count are not predictive of bleeding in cirrhosis and may lead providers to overestimate bleeding risk. Hepatic decompensation, kidney injury, metabolic syndrome, alcohol use, and infections are all associated with increased bleeding risk. Procedure type, urgency, and operator experience also influence procedural bleeding risk. Historically pre-procedural transfusion support has been used in attempt to mitigate procedural bleeding risk. However, mounting data argues against this approach. Patient optimization, procedure conditions, and procedure technique can minimize bleeding risk. Viscoelastic testing may be useful to reduce the use of prophylactic transfusion and reassure proceduralists.
conclusionHistorically, the risk of procedural bleeding has been overestimated in patients with cirrhosis due to abnormal conventional coagulation testing including prolonged prothrombin time and thrombocytopenia. Prophylactic transfusion has not been consistently demonstrated to reduce bleeding risk and carries some risks. Performing only necessary procedures under optimal conditions with safe technique and preparation for rescue transfusion can minimize procedural-associated bleeding and its consequences.
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Registered trials
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.