News from the AGA

Change in testing protocol for cirrhosis


 

Patients with cirrhosis, or permanent liver damage, are at higher risk for coagulation disorders, which impact your body’s ability to control blood clotting. This puts cirrhosis patients at increased risk of morbidity and mortality when undergoing diagnostic or therapeutic invasive procedures. AGA has released new clinical guidelines to change how you identify and treat coagulation disorders in patients with cirrhosis. In this new guidance, AGA recommends against the use of extensive preprocedural testing to estimate clotting in patients with cirrhosis. These guidelines, which were developed after a detailed review of available literature, are published in Gastroenterology, AGA’s official journal.

Key guideline recommendations:

  • Extensive preprocedural testing, including measurements of prothrombin time/international normalized ratio or platelet count, should not routinely be performed in patients with stable cirrhosis undergoing common GI procedures.
  • Blood products, including fresh frozen plasma or platelet transfusion, should not routinely be used for bleeding prophylaxis in patients with stable cirrhosis undergoing common GI procedures.
  • Standard pharmacologic venous thromboembolism prophylaxis should be given to hospitalized patients with cirrhosis like other medical patients.
  • Anticoagulation should be used to treat acute or subacute nontumoral portal vein thrombosis in patients with cirrhosis to improve patient outcomes.

Learn more in the AGA GI Patient Center. Read the AGA Clinical Practice Guidelines on the Management of Coagulation Disorders in Patients with Cirrhosis to review the complete recommendations.

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