{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:00:30Z","timestamp":1790719230187,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,12,11]],"date-time":"2012-12-11T00:00:00Z","timestamp":1355184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Aims<\/jats:title><jats:p>Cirrhosis presents with variable degrees of thrombocytopenia that might cause bleeding during invasive procedures. Transfusion of one standard adult platelet dose is often employed to prevent bleeding in thrombocytopenia, but the threshold platelet count that is clinically effective is not well established because clinical studies and laboratory tools to judge on efficacy are insufficient. However, <jats:italic>in vitro<\/jats:italic> studies showed that patients with cirrhosis generate as much thrombin as healthy individuals provided that their platelet count is at least 100\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To assess the <jats:italic>in vivo<\/jats:italic> relevance of these <jats:italic>in vitro<\/jats:italic> studies, we investigated 26 thrombocytopenic patients with cirrhosis, undergoing 36 variceal ligations, to see whether transfusion of one standard adult platelet dose was able to attain the above platelet count. We also evaluated the effect of platelet transfusion on such global hemostasis tests as thrombin generation and thromboelastometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Transfusion did slightly increase platelet count [pre\u2010 vs. post\u2010infusion: 39\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L(16\u201064) vs. 52\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L(19\u201091), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001], without significant effect on thrombin generation, probably because post\u2010transfusion platelet count was less than the target of 100\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L in all patients. In addition, the percentage of patients with abnormal thrombin generation (i.e. below the lower limit of normal range) was scarcely affected by transfusion (pre\u2010 vs. post\u2010infusion: 36% vs. 42%). The small post\u2010transfusion increase in platelet count was paralleled by some degree of improvement of thromboelastometry, but none of the patients reached normal values after transfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Infusing one standard adult platelet dose secures only a small increase in platelet count without normalizing thrombin generation and thromboelastometry tests. To obtain greater increases in platelet count and normalization of laboratory tests more intensive platelet transfusions or treatment with non\u2010transfusional drugs are probably needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12038","type":"journal-article","created":{"date-parts":[[2012,11,8]],"date-time":"2012-11-08T08:11:13Z","timestamp":1352362273000},"page":"362-367","source":"Crossref","is-referenced-by-count":114,"title":["Global hemostasis tests in patients with cirrhosis before and after prophylactic platelet transfusion"],"prefix":"10.1111","volume":"33","author":[{"given":"Armando","family":"Tripodi","sequence":"first","affiliation":[{"name":"Angelo Bianchi Bonomi Hemophilia and Thrombosis Center Department of Clinical Sciences and Community Health Universit\u00e0 degli Studi di, Milano"},{"name":"IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Primignani","sequence":"additional","affiliation":[{"name":"First Division of Gastroenterology IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"},{"name":"IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veena","family":"Chantarangkul","sequence":"additional","affiliation":[{"name":"Angelo Bianchi Bonomi Hemophilia and Thrombosis Center Department of Clinical Sciences and Community Health Universit\u00e0 degli Studi di, Milano"},{"name":"IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lemma","sequence":"additional","affiliation":[{"name":"Angelo Bianchi Bonomi Hemophilia and Thrombosis Center Department of Clinical Sciences and Community Health Universit\u00e0 degli Studi di, Milano"},{"name":"IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manol","family":"Jovani","sequence":"additional","affiliation":[{"name":"First Division of Gastroenterology IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"},{"name":"IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Rebulla","sequence":"additional","affiliation":[{"name":"Center of Transfusion Medicine IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"},{"name":"IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier M.","family":"Mannucci","sequence":"additional","affiliation":[{"name":"Scientific direction IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"},{"name":"IRCCS C\u00e0 Granda Ospedale Maggiore Foundation Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,12,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011170"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0b013e32830a9746"},{"key":"e_1_2_6_4_1","first-page":"289","volume-title":"Chronic Liver Failure: Mechanisms and Management","author":"Tripodi A","year":"2010"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.06.008"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1538-7836.2003.00260.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21231"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21266"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1989.29789369678.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000071636"},{"key":"e_1_2_6_11_1","first-page":"547","article-title":"Thrombin generation assessed as endogenous thrombin potential (ETP) in patients with hypo\u2010 or hyper\u2010coagulability. 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