2020
DOI: 10.1055/s-0040-1715451
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Abstract: Thrombocytopenia is one of the most common hematologic complications in cirrhosis. Despite limited data linking platelet count and bleeding risk in patients with cirrhosis, the use of platelets transfusions for invasive procedures has been a common practice. Recently, thrombopoietin (TPO) receptor agonists have been approved for use in patients with chronic liver disease (CLD) undergoing invasive procedures. The aim of this study was to review current literature on bleeding risk in patients with cirrhosis and … Show more

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Cited by 20 publications
(12 citation statements)
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“…Some studies found an association between TPO-RA and incidence of VTE and arterial thrombosis in patients with chronic liver disease or acquired thrombophilia, such as aPL-positivity or APS. This may be due to the potential role of TPO-RA in enhancing the autoimmune response [ 59 ].…”
Section: Management Of Apl-associated Thrombocytopeniamentioning
confidence: 99%
“…Some studies found an association between TPO-RA and incidence of VTE and arterial thrombosis in patients with chronic liver disease or acquired thrombophilia, such as aPL-positivity or APS. This may be due to the potential role of TPO-RA in enhancing the autoimmune response [ 59 ].…”
Section: Management Of Apl-associated Thrombocytopeniamentioning
confidence: 99%
“…63 In patients with platelet counts <50 × 10 9 /L, avatrombopag and lusutrombopag increased the platelet counts adequately and reduced the frequency of platelet transfusions. [63][64][65] Maximum platelet counts were achieved at around 12 days from the first dose with the counts returning to patients' baseline levels by day 35. 64,65 A recent meta-analysis from Italy that included almost 2000 patients concluded a 1.6% risk of portal vein thrombosis with TPO-RA versus 0.6% in the placebo group with a significant association observed only with eltrombopag.…”
Section: Thrombopoietin Receptor Agonistsmentioning
confidence: 98%
“…As an alternative to platelet transfusions, three thrombopoeitin receptor agonists (TPO‐RA) have been trialled in patients with liver disease who had thrombocytopenia: eltrombopag, avatrombopag, and lusutrombopag. Of these, the last two have obtained approval for use in patients with chronic liver disease (CLD) undergoing invasive procedures 63 . In patients with platelet counts <50 × 10 9 /L, avatrombopag and lusutrombopag increased the platelet counts adequately and reduced the frequency of platelet transfusions 63‐65 .…”
Section: Benefits/risks Of Interventions To Address Thrombocytopenia In the Periprocedural Settingmentioning
confidence: 99%
“…Recently, thrombopoietin receptor agonists (avatrombopag and lusutrombopag) were approved by the United States Food and Drug Administration for the non-invasive treatment of thrombocytopenia in patients with chronic liver disease undergoing a surgical procedure. These new drugs are considered safe and effective alternatives to platelet transfusions[ 31 , 32 ].…”
Section: Which Is the Best Treatment Approach–conservative Treatment Or Urgent Surgery?mentioning
confidence: 99%