How do we transfuse blood components in cirrhotic patients undergoing gastrointestinal procedures?

Sean Yates, Chakri Gavva, Deepak Agrawal, Ravi Sarode

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The liver plays a pivotal role in hemostasis. Consequently, patients with cirrhosis frequently demonstrate abnormal coagulation profiles on routine laboratory tests. These tests mainly reflect decreased procoagulant proteins. However, in cirrhosis, complex changes also occur in anticoagulant and fibrinolytic pathways. Recent evidence demonstrates that patients with cirrhosis exist in a state of hemostatic rebalance. Accordingly, routine tests inadequately represent hemostatic alterations in these patients. Unfortunately, these tests are regularly used to guide the transfusion of blood components with the assumption that they will correct laboratory abnormalities and improve hemostasis in a bleeding patient or prevent excessive bleeding following a procedure. With an absence of both accurate laboratory testing to assess hemostasis and evidence-based guidelines to direct the transfusion of blood components, management of patients with cirrhosis poses a significant challenge to clinicians. Therefore, we developed multidisciplinary guidelines for the periprocedural transfusion of blood components in patients with cirrhosis based on concurrent evidence and personal experience at our medical center.

Original languageEnglish (US)
Pages (from-to)791-798
Number of pages8
JournalTransfusion
Volume56
Issue number4
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Fingerprint

Blood Component Transfusion
Fibrosis
Hemostasis
Hemostatics
Guidelines
Hemorrhage
Anticoagulants
Liver
Proteins

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology

Cite this

How do we transfuse blood components in cirrhotic patients undergoing gastrointestinal procedures? / Yates, Sean; Gavva, Chakri; Agrawal, Deepak; Sarode, Ravi.

In: Transfusion, Vol. 56, No. 4, 01.04.2016, p. 791-798.

Research output: Contribution to journalArticle

Yates, Sean ; Gavva, Chakri ; Agrawal, Deepak ; Sarode, Ravi. / How do we transfuse blood components in cirrhotic patients undergoing gastrointestinal procedures?. In: Transfusion. 2016 ; Vol. 56, No. 4. pp. 791-798.
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