Optimizing Blood-Product Use Before Invasive Procedures in Patients with Cirrhosis

Patients with cirrhosis have elevated bleeding risk during invasive procedures. Routine coagulation parameters, such as prothrombin time and platelet count, may mischaracterize that risk as operators prepare to infuse fresh frozen plasma (FFP), platelets, or both. Thromboelastography (TEG) assesses coagulation more globally by measuring real-time viscoelastic changes during the hemostatic process.

Researchers assessed how well TEG guides blood-product transfusions in patients with cirrhosis and impaired coagulation parameters (international normalized ratio >1.8, platelet count <50,000/μL, or both). In an open-label trial, they randomized 60 such patients — 28 undergoing invasive procedures with low (<3%) bleeding risk and 32 undergoing proc…