Implementing pre-procedural thrombopoietin receptor agonists in cirrhotic patients with severe thrombocytopenia: Indiscriminate, selective or unneeded?

Recent studies promote thrombopoietin-receptor agonists (TRAs), instead of platelet transfusions, before elective invasive procedures in patients with cirrhosis and platelet count below 50  × 109/L [1–6] to prevent procedure-related bleeding. In the current issue of Digestive and Liver Disease the systematic review and meta-analysis by Rose and colleagues [7] confirms that TRAs significantly decrease the amount of the supposed required platelet transfusions. At variance with plat elet transfusions, which have a slight and short-term effect on the platelet count, second generation TRAs more often achieve a predictable and persistent increase of the platelet count above the conventional threshold of 50 × 109/L, thus allegedly providing higher protection against peri‑proce dural and delayed bleeding.
Source: Digestive and Liver Disease - Category: Gastroenterology Authors: Tags: Commentary Source Type: research