Treatment Options for Thrombocytopenia in Patients With Chronic Liver Disease Undergoing a Scheduled Procedure

被引:7
|
作者
Saab, Sammy [1 ]
Bernstein, David [4 ]
Hassanein, Tarek [2 ]
Kugelmas, Marcelo [5 ]
Kwo, Paul [3 ]
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA
[2] Southern Calif Res Ctr, San Diego, CA USA
[3] Stanford Univ, Med Ctr, Palo Alto, CA 94304 USA
[4] Northwell Hlth, Manhasset, NY USA
[5] South Denver Gastroenterol PC, Englewood, CO USA
关键词
thrombocytopenia; chronic liver disease; treatment; procedure; ACTIVATION IN-VITRO; HEPATITIS-C; GASTROESOPHAGEAL VARICES; HEPATOCELLULAR-CARCINOMA; AMERICAN ASSOCIATION; PORTAL-HYPERTENSION; INDUCED CIRRHOSIS; PRACTICE GUIDANCE; UNITED-STATES; THROMBOPOIETIN;
D O I
10.1097/MCG.0000000000001338
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Thrombocytopenia is a consequence of portal hypertension and is the most common hematological manifestation of chronic liver disease (CLD) (ie, cirrhosis). Data indicates the rates of CLD are increasing and, as a result, so will the incidence of this complication. Although bleeding risks are only relevant when elective procedures are performed, this is a frequent concern as these procedures are commonly part of the spectrum of care for patients with cirrhosis. As such, thrombocytopenia remains a pertinent issue. Fortunately, we now have effective and accurate treatment modalities to raise platelet counts before scheduled procedures, known as thrombopoietin receptor agonists. Two drugs in this therapeutic class (avatrombopag and lusutrombopag) are now approved for the treatment of thrombocytopenia in adults with CLD undergoing a procedure and have revolutionized how this is managed. Although there is progress in the field, peer-reviewed literature and expert guidance are lacking. Recognizing these unmet needs, a group of expert hepatologists comprised this review, which summarizes the most current and relevant peer-reviewed literature on thrombocytopenia in CLD and provides clinical expertise on this timely topic.
引用
收藏
页码:503 / 511
页数:9
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