Research needs in periprocedural management of hemostasis as proposed by European Association for Study of the Liver5
| Large prospective observational collaborative studies to • establish the incidence of procedural bleeding • evaluate associations between anemia +/- thrombocytopenia and procedural bleeding • assess relationship between fibrinogen deficiency and procedural bleeding • explore the impact of a hyperfibrinolytic state on procedural bleeding |
| Evaluate the role of viscoelastic tests in predicting procedural bleeding in patients undergoing high-risk procedures (including adequate numbers of patients with progressive disease severity [ie, compensated, acute decompensation, acute on chronic liver failure]) |
| Randomized, placebo-controlled trials in patients with severe thrombocytopenia undergoing high-risk procedures, to assess the role of 1) platelet transfusions and 2) thrombopoietin-receptor agonists, with clinically significant bleeding as the primary endpoint |
| Clinical trials to evaluate antifibrinolytics in the periprocedural setting, particularly in patients with known/suspected hyperfibrinolysis |
| Large prospective observational collaborative studies to • establish the incidence of procedural bleeding • evaluate associations between anemia +/- thrombocytopenia and procedural bleeding • assess relationship between fibrinogen deficiency and procedural bleeding • explore the impact of a hyperfibrinolytic state on procedural bleeding |
| Evaluate the role of viscoelastic tests in predicting procedural bleeding in patients undergoing high-risk procedures (including adequate numbers of patients with progressive disease severity [ie, compensated, acute decompensation, acute on chronic liver failure]) |
| Randomized, placebo-controlled trials in patients with severe thrombocytopenia undergoing high-risk procedures, to assess the role of 1) platelet transfusions and 2) thrombopoietin-receptor agonists, with clinically significant bleeding as the primary endpoint |
| Clinical trials to evaluate antifibrinolytics in the periprocedural setting, particularly in patients with known/suspected hyperfibrinolysis |