The role of thrombocytopenia in the clinical management of patients with liver cirrhosis: opinion of experts in therapeutic and surgical hepatology

Abstract

Seven of the country’s leading  experts  in the field of therapeutic and surgical hepatology answer  questions on this issue: how relevant  is thrombocytopenia in patients with CLD for clinical practice, what  is the  average  proportion  of patients who need correction  of thrombocytopenia before scheduled and emergency  surgical/invasive interventions and how is thrombocytopenia correction  performed. All experts  are unanimous in the opinion that thrombocytopenia is most common at the stage  of cirrhosis. Further, the experts  discussed  the issues of the total number of patients with CLD, the proportion  of patients with thrombocytopenia at all, the proportion  of patients with thrombocytopenia in need of surgical interventions, the experts were asked to provide schemes  for correcting  thrombocytopenia, which they use in their  clinical practice. The focus of the  experts’ attention was on the discussion of patients who have a platelet level of less than 50 000/µl and need scheduled surgical interventions / invasive procedures. All experts  unanimously stratify these  interventions according to the risk of hemorrhagic complications:  high – more than  1.5%, low – less than  1.5%. The most common and available  method  for the correction  of thrombocytopenia at present is platelet transfusion. Details of all this information, as well as statistical data, can be found in this article.