Short Communication
Volume 8 Issue 12 - 2021
Platelet Transfusion in Patients with Chronic Liver Disease-Associated Severe Thrombocytopenia Undergoing Invasive Procedures in Spain. Challenges and Opportunities during the COVID-19 Pandemic

Isidro Jarque-Ramos1, Maria Eva Mingot-Castellano2, Maria Dolores Fernández-Herrera3 and Alicia Gil4*

1Hospital Universitari i Politècnic La Fe, Valencia, Spain
2Hospital Universitario Virgen del Rocío, Sevilla, Spain
3Centro de Transfusión, Tejidos y Células, Huelva, Spain
4Omakase Consulting S.L., Barcelona, Spain
*Corresponding Author: Alicia Gil, Omakase Consulting S.L., Barcelona, Spain.
Received: November 12, 2021; Published: November 25, 2021

Severe thrombocytopenia (TCP), defined as a platelet count < 50 x 109/L, is a rare complication affecting approximately 1% of chronic liver disease (CLD) patients. Moreover, in the course of CLD, patients often undergo invasive diagnostic and therapeutic procedures. Severe TCP can increase the perioperative bleeding risk, causing morbidity and cancellations of scheduled interventions [1-3].

There are currently no clinical guidelines in Spain for the management of these patients. Nevertheless, in current clinical practice in Spain, most patients with CLD and severe TCP who undergo invasive procedures receive prophylactic platelet transfusions (PTs) [4], in line with international recommendations [5].


  1. Afdhal N., et al. “Thrombocytopenia associated with chronic liver disease”. Journal of Hepatology 48 (2008): 1000-1007.
  2. Peck-Radosavljevic M. “Thrombocytopenia in chronic liver disease”. Liver International 37 (2017): 778-793.
  3. Moore AH. “Thrombocytopenia in Cirrhosis: A Review of Pathophysiology and Management Options”. Clinical Liver Disease 14 (2019): 183-186.
  4. Fortea JI., et al. “Management of haemostatic alterations and associated disorders in cirrhosis in Spain: A national survey”. Digestive and Liver Disease 51 (2019): 95-103.
  5. Nagrebetsky A., et al. “Perioperative thrombocytopenia: evidence, evaluation, and emerging therapies”. British Journal of Anaesthesia 122 (2019): 19-31.
  6. Alcaina PS. “Platelet Transfusion: And Update on Challenges and Outcomes”. Journal of Blood Medicine 11 (2020): 19-26.
  7. Stanworth SJ., et al. “Effects of the COVID-19 pandemic on supply and use of blood for transfusion”. Lancet Haematology 7 (2020): e756-e764.
  8. García-Erce JA., et al. “Blood donations and transfusions during the COVID-19 pandemic in Spain: Impact according to autonomous communities and hospitals”. International Journal of Environmental Research and Public Health 7 (2021): 3480.
  9. Desborough MJR., et al. “Alternatives to allogeneic platelet transfusion”. British Journal of Haematology 3 (2016): 381-392.
  10. Agencia Estatal Boletín Oficial del Estado. Real Decreto 1945/1985, de 9 de octubre, por el que se regula la hemodonación y los Bancos de Sangre. n.d.
  11. Gil A., et al. “Cost associated with the management of chronic liver disease-associated severe thrombocytopenia in adult patients undergoing invasive procedures in Spain”. Value in Health 22 (2019): S711.
  12. EMA (European Medicines Agency). Summary of product characteristics. Mulpleo (lusutrombopag) n.d.
  13. EMA (European Medicines Agency). Summary of product characteristics. Doptelet (avatrombopag) n.d.
Citation: Alicia Gil., et al. “Platelet Transfusion in Patients with Chronic Liver Disease-Associated Severe Thrombocytopenia Undergoing Invasive Procedures in Spain. Challenges and Opportunities during the COVID-19 Pandemic”. EC Gastroenterology and Digestive System 8.12 (2021): 84-86.

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