24th July 2024

Liver disease

Liver disease is a heterogeneous condition with complex interplay between different bleeding and thrombotic mechanisms. It is no longer thought that patients with liver disease are only more prone to bleeding – there is often both a prothrombotic and concomitant pro-bleeding state.

Common haematological derangements in liver disease include:

Platelets are often transfused once below 50 x 10-9 but INR is not routinely corrected.

For common procedures encountered in liver disease such as paracentesis, pre-procedure prophylaxis is not routinely recommended owing to the low bleeding risk. Prior to invasive procedures, a discussion between haematologists and hepatologists is advised to assess the overall bleeding/coagulable state of a given patient.