Bleeding Risk and Management in Interventional Procedures in Chronic Liver Disease.
The coagulopathy of liver disease is distinctly different from therapeutic anticoagulation in a patient. Despite stable elevated standard clot-based coagulation assays, nearly all patients with stable chronic liver disease (CLD) have normal or increased clotting. Common unfamiliarity with the limitations of these assays in CLD may lead to inappropriate and sometimes harmful interventions, including blood product transfusions before a procedure. Knowledge of the distinct hemostatic alterations in CLD can allow identification of the small subset of patients with clinically significant coagulopathy who can benefit from hematologic optimization before invasive procedures.
Department of Radiology and Medical Imaging, University of Virginia Health System, Box 800170, Charlottesville, VA 22908. Electronic address: gad9a@virginia.edu.
Gia A
GA
DeAngelis
Department of Radiology and Medical Imaging, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
Rachita
R
Khot
Department of Radiology and Medical Imaging, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
Ziv J
ZJ
Haskal
Division of Hematology/Oncology, Department of Medicine, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
Hillary S
HS
Maitland
Coagulation in Liver Disease Study Group, Division of Gastroenterology and Hepatology, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
Patrick G
PG
Northup
Coagulation in Liver Disease Study Group, Division of Gastroenterology and Hepatology, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
Neeral L
NL
Shah
Coagulation in Liver Disease Study Group, Division of Gastroenterology and Hepatology, University of Virginia Health System, Box 800170, Charlottesville, VA 22908.
Stephen H
SH
Caldwell
D000818:Animals; D001778:Blood Coagulation Disorders / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001780:Blood Coagulation Tests; D001803:Blood Transfusion; D002908:Chronic Disease; D057510:Endovascular Procedures / Q000009:adverse effects; D006401:Hematologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006470:Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D006487:Hemostasis; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010979:Platelet Function Tests; D018570:Risk Assessment; D012307:Risk Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome
D006401:Hematologic Agents