{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:01:01Z","timestamp":1790719261986,"version":"4.1.0"},"reference-count":87,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gaps of knowledge still exist about the potential association between severe thrombocytopenia and increased risk of procedure\u2010associated bleeding in patients with liver disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this narrative review, we aimed at examining the association between procedure\u2010related bleeding risk and platelet count in patients with cirrhosis and severe thrombocytopenia in various settings. We updated to 2020 a previously conducted literature search using MEDLINE\/PubMed and EMBASE. The search string included clinical studies, adult patients with chronic liver disease and thrombocytopenia undergoing invasive procedures, any interventions and comparators, and haemorrhagic events of any severity as outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The literature search identified 1276 unique publications, and 15 studies met the inclusion criteria and were analysed together with those identified by the previous search. Most of the new studies included in our analysis did not assess the association between post\u2010procedural bleeding risk and platelet count alone in patients with chronic liver disease. Furthermore, some results could have been biased by prophylactic platelet transfusions. A few studies found that severe thrombocytopenia may be predictive of bleeding following percutaneous liver biopsy, dental extractions, percutaneous ablation of liver tumours and endoscopic polypectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Currently available literature cannot support definitive conclusions about the appropriate target platelet counts to improve the risk of bleeding in cirrhotic patients who underwent invasive procedures; moreover, it showed enormous variability in the use of prophylactic platelet transfusions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eci.13508","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T02:14:08Z","timestamp":1612577648000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Procedure\u2010related bleeding risk in patients with cirrhosis and severe thrombocytopenia"],"prefix":"10.1111","volume":"51","author":[{"given":"Domenico","family":"Alvaro","sequence":"first","affiliation":[{"name":"Department of Translational and Precision Medicine Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Caporaso","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery University of Naples 'Federico II' Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8526-837X","authenticated-orcid":false,"given":"Edoardo Giovanni","family":"Giannini","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit Department of Internal Medicine University of Genoa, IRCCS\u2010Ospedale Policlinico San Martino Genoa 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