{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:43:16Z","timestamp":1788262996043,"version":"build-2803163510"},"reference-count":36,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T00:00:00Z","timestamp":1637280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Second-generation thrombopoietin receptor agonists (TPO-RAs) are emerging as the new standard for managing thrombocytopenia (TCP) in patients with chronic liver diseases (CLDs) undergoing scheduled procedures. However, practical guidance for their routine use in CLD patients undergoing specific invasive procedures is lacking. Methods: These practice guidelines were developed by the Initiative Group for Central European Hepatologic Collaboration (CEHC), composed of nine hepatologist\/gastroenterologist experts from Central Europe. Using an adapted Delphi process, the CEHC group selected ten invasive procedures most relevant to the hepatology\/gastroenterology setting in the region. Consensus recommendations for each invasive procedure are reported as a final percentage of expert panel responses. Results: A consensus was agreed that TPO-RAs should be considered for raising platelet count in CLD patients undergoing scheduled abdominal surgery, high-bleeding risk dentistry, endoscopic polypectomy, endoscopic variceal ligation, liver biopsy, liver surgery, liver transplantation and percutaneous ablation, but it was also agreed that they are less beneficial or not necessary for endoscopy without intervention and paracentesis. Conclusions: Using a modified Delphi method, experts reached an agreement for TCP management in CLD patients undergoing ten invasive procedures. These practice guidelines may help with decision making and patient management in areas where clinical evidence is absent or limited.<\/jats:p>","DOI":"10.3390\/jcm10225419","type":"journal-article","created":{"date-parts":[[2021,11,21]],"date-time":"2021-11-21T20:58:21Z","timestamp":1637528301000},"page":"5419","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3394-1635","authenticated-orcid":false,"given":"Robert","family":"Flisiak","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Hepatology, Medical University of Bia\u0142ystok, Zurawia 14, 15-540 Bia\u0142ystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3135-7267","authenticated-orcid":false,"given":"Krasimir","family":"Antonov","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital \u2018St. Ivan Rilski\u2019, 1431 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5656-9242","authenticated-orcid":false,"given":"Pavel","family":"Drastich","sequence":"additional","affiliation":[{"name":"Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Jarcuska","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Faculty of Medicine and L. Pasteur University Hospital, P.J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Maevskaya","sequence":"additional","affiliation":[{"name":"Clinic of Propedeutics of Internal Diseases, Gastroenterology and Hepatology Named after V. Kh. Vasilenko, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation, 119435 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mih\u00e1ly","family":"Makara","sequence":"additional","affiliation":[{"name":"Central Hospital of Southern Pest National Institute of Haematology and Infectious Diseases, 1097 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u017deljko","family":"Puljiz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital Split, Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borut","family":"\u0160tabuc","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9144-5520","authenticated-orcid":false,"given":"Anca","family":"Trifan","sequence":"additional","affiliation":[{"name":"Department of Internal Diseases, Institute of Gastroenterology and Hepatology Lasi, University of Medicine and Pharmacy \u201cGr. T. Popa\u201d, 700115 Lasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/liv.13682","article-title":"Liver diseases: A major, neglected global public health problem requiring urgent actions and large-scale screening","volume":"38","author":"Marcellin","year":"2018","journal-title":"Liver Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jpainsymman.2016.03.013","article-title":"Significant morbidity and mortality among hospitalized end-stage liver disease patients in Medicare","volume":"52","author":"Brown","year":"2016","journal-title":"J. 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