Periprocedural management of abnormal coagulation parameters and thrombocytopenia in patients with cirrhosis: Guidance from the SSC of the ISTH

J Thromb Haemost. 2022 Jan;20(1):39-47. doi: 10.1111/jth.15562. Epub 2021 Nov 8.


Prolonged prothrombin time and thrombocytopenia are common in patients with cirrhosis. These parameters do not reflect the overall hemostatic rebalance or bleeding risk in the periprocedural setting; however, attempts to correct these parameters remain frequent. We review the literature on periprocedural bleeding risk, bleeding risk factors, and the risk and benefits of hemostatic interventions in patients with cirrhosis. We provide guidance recommendations on evaluating bleeding risk in this patient group and management of hemostatic abnormalities in the periprocedural setting.

Keywords: cirrhosis; hemorrhage; hemostasis; liver diseases; thrombocytopenia.

Publication types

  • Review

MeSH terms

  • Blood Coagulation
  • Blood Coagulation Disorders* / etiology
  • Hemostasis
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Thrombocytopenia* / complications
  • Thrombocytopenia* / diagnosis
  • Thrombocytopenia* / therapy