Best Practice Advice on Coagulation in Patients with Cirrhosis

Complications from both pro- and antithrombotic states are seen in patients with cirrhosis. Therefore, a common scenario for the clinician is considering anticoagulation in a patient while worrying about bleeding risk.

Four experts reviewed the current and evolving data on coagulation in this population and provided clinical practice advice, including the following:

• Clinicians should not routinely correct thrombocytopenia and coagulopathy for low-risk procedures such as band ligation of varices, paracentesis, and thoracentesis.

• For active bleeding and to minimize bleeding in high-risk procedures:

  • A platelet count target >50,000 is still advised.

  • Less reliance on international normalized ratio (INR) as a measure of hemostasis is advised.

  • New meas…