Correction of Thrombocytopenia before Elective Surgery / Invasive Procedures in Patients with Liver Cirrhosis (Experts’ Agreement)
Introduction. As a result of portal hypertension (sequestration of platelets in an enlarged spleen) and liver failure (decreased production of thrombopoietin in the liver) in liver cirrhosis, thrombocytopenia develops, which is associated with the risk of periprocedural/perioperative bleeding compli...
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Gastro LLC
2024-08-01
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| Series: | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
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| Online Access: | https://www.gastro-j.ru/jour/article/view/1383 |
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| author | M. V. Maevskaya M. Yu. Nadinskaia E. N. Bessonova N. I. Geyvandova M. S. Zharkova E. A. Kitsenko N. V. Korochanskaya I. A. Kurkina A. L. Melikyan V. G. Morozov Yu. V. Khoronko T. A. Deeva K. A. Gulyaeva V. T. Ivashkin |
| author_facet | M. V. Maevskaya M. Yu. Nadinskaia E. N. Bessonova N. I. Geyvandova M. S. Zharkova E. A. Kitsenko N. V. Korochanskaya I. A. Kurkina A. L. Melikyan V. G. Morozov Yu. V. Khoronko T. A. Deeva K. A. Gulyaeva V. T. Ivashkin |
| author_sort | M. V. Maevskaya |
| collection | DOAJ |
| description | Introduction. As a result of portal hypertension (sequestration of platelets in an enlarged spleen) and liver failure (decreased production of thrombopoietin in the liver) in liver cirrhosis, thrombocytopenia develops, which is associated with the risk of periprocedural/perioperative bleeding complications. There are still unresolved questions regarding risk stratification of bleeding complications, the prognostic role of thrombocytopenia, as well as the need for treatment of thrombocytopenia and its methods.Materials and methods. The Russian Scientific Liver Society selected a panel of experts in the field of therapeutic and surgical hepatology, hematology, transfusion medicine to make reasoned statements and recommendations on the issue of treatment of thrombocytopenia before elective surgery / invasive procedures in patients with liver cirrhosis.Results. Relevant clinical issues were determined based on the PICO principle (patient or population, intervention, comparison, outcome). The Delphi panel made five questions and gave reasoned answers, framed as ‘clinical practice recommendations and statements’ with evidence-based comments. The questions and statements were based on the results of search and critical analysis of medical literature using keywords in English- and Russian-language databases. The formulated questions could be combined into four categories: bleeding risk stratification, the prognostic value of thrombocytopenia, the necessity and methods of thrombocytopenia drug correction, and bleeding risk reduction.Conclusions. The results of experts' work are directly related to high-quality management of patients with liver cirrhosis and thrombocytopenia, who have scheduled invasive procedures/surgery. Thus, this recommendations and statements can be used in clinical practice. |
| format | Article |
| id | doaj-art-b386bf93f6834d9dbfe6e6aca09034ee |
| institution | Kabale University |
| issn | 1382-4376 2658-6673 |
| language | Russian |
| publishDate | 2024-08-01 |
| publisher | Gastro LLC |
| record_format | Article |
| series | Российский журнал гастроэнтерологии, гепатологии, колопроктологии |
| spelling | doaj-art-b386bf93f6834d9dbfe6e6aca09034ee2025-02-10T16:14:39ZrusGastro LLCРоссийский журнал гастроэнтерологии, гепатологии, колопроктологии1382-43762658-66732024-08-0134311513410.22416/1382-4376-2024-1032-2784937Correction of Thrombocytopenia before Elective Surgery / Invasive Procedures in Patients with Liver Cirrhosis (Experts’ Agreement)M. V. Maevskaya0M. Yu. Nadinskaia1E. N. Bessonova2N. I. Geyvandova3M. S. Zharkova4E. A. Kitsenko5N. V. Korochanskaya6I. A. Kurkina7A. L. Melikyan8V. G. Morozov9Yu. V. Khoronko10T. A. Deeva11K. A. Gulyaeva12V. T. Ivashkin13I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)Ural State Medical University; Sverdlovsk Regional Clinical Hospital No. 1Stavropol State Medical University; Stavropol Regional Clinical HospitalI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Scientific Center of Surgery named after Academician B.V. PetrovskyKuban State Medical University; Regional Clinical Hospital No. 2I.M. Sechenov First Moscow State Medical University (Sechenov University)National Medical Research Center for HematologyMedical Company “Hepatologist”Rostov State Medical UniversityI.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)I.M. Sechenov First Moscow State Medical University (Sechenov University)Introduction. As a result of portal hypertension (sequestration of platelets in an enlarged spleen) and liver failure (decreased production of thrombopoietin in the liver) in liver cirrhosis, thrombocytopenia develops, which is associated with the risk of periprocedural/perioperative bleeding complications. There are still unresolved questions regarding risk stratification of bleeding complications, the prognostic role of thrombocytopenia, as well as the need for treatment of thrombocytopenia and its methods.Materials and methods. The Russian Scientific Liver Society selected a panel of experts in the field of therapeutic and surgical hepatology, hematology, transfusion medicine to make reasoned statements and recommendations on the issue of treatment of thrombocytopenia before elective surgery / invasive procedures in patients with liver cirrhosis.Results. Relevant clinical issues were determined based on the PICO principle (patient or population, intervention, comparison, outcome). The Delphi panel made five questions and gave reasoned answers, framed as ‘clinical practice recommendations and statements’ with evidence-based comments. The questions and statements were based on the results of search and critical analysis of medical literature using keywords in English- and Russian-language databases. The formulated questions could be combined into four categories: bleeding risk stratification, the prognostic value of thrombocytopenia, the necessity and methods of thrombocytopenia drug correction, and bleeding risk reduction.Conclusions. The results of experts' work are directly related to high-quality management of patients with liver cirrhosis and thrombocytopenia, who have scheduled invasive procedures/surgery. Thus, this recommendations and statements can be used in clinical practice.https://www.gastro-j.ru/jour/article/view/1383picothrombocytopeniahemostasisbleeding complicationsthrombosisthrombocytopenia correctionthrombopoietin receptor agoniststpo-raseltrombopaglusutrombopagavatrombopag, romiplostim |
| spellingShingle | M. V. Maevskaya M. Yu. Nadinskaia E. N. Bessonova N. I. Geyvandova M. S. Zharkova E. A. Kitsenko N. V. Korochanskaya I. A. Kurkina A. L. Melikyan V. G. Morozov Yu. V. Khoronko T. A. Deeva K. A. Gulyaeva V. T. Ivashkin Correction of Thrombocytopenia before Elective Surgery / Invasive Procedures in Patients with Liver Cirrhosis (Experts’ Agreement) Российский журнал гастроэнтерологии, гепатологии, колопроктологии pico thrombocytopenia hemostasis bleeding complications thrombosis thrombocytopenia correction thrombopoietin receptor agonists tpo-ras eltrombopag lusutrombopag avatrombopag, romiplostim |
| title | Correction of Thrombocytopenia before Elective Surgery / Invasive Procedures in Patients with Liver Cirrhosis (Experts’ Agreement) |
| title_full | Correction of Thrombocytopenia before Elective Surgery / Invasive Procedures in Patients with Liver Cirrhosis (Experts’ Agreement) |
| title_fullStr | Correction of Thrombocytopenia before Elective Surgery / Invasive Procedures in Patients with Liver Cirrhosis (Experts’ Agreement) |
| title_full_unstemmed | Correction of Thrombocytopenia before Elective Surgery / Invasive Procedures in Patients with Liver Cirrhosis (Experts’ Agreement) |
| title_short | Correction of Thrombocytopenia before Elective Surgery / Invasive Procedures in Patients with Liver Cirrhosis (Experts’ Agreement) |
| title_sort | correction of thrombocytopenia before elective surgery invasive procedures in patients with liver cirrhosis experts agreement |
| topic | pico thrombocytopenia hemostasis bleeding complications thrombosis thrombocytopenia correction thrombopoietin receptor agonists tpo-ras eltrombopag lusutrombopag avatrombopag, romiplostim |
| url | https://www.gastro-j.ru/jour/article/view/1383 |
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