Thrombocytopenia in Chronic Liver Disease: New Management Strategies

Kathy M. Nilles, Steven L. Flamm*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Thrombocytopenia is common in advanced liver disease, and such patients frequently need invasive procedures. Numerous mechanisms for thrombocytopenia exist, including splenic sequestration and reduction of levels of the platelet growth factor thrombopoietin. Traditionally, platelet transfusions have been used to increase platelet counts before elective procedures, usually to a threshold of greater than or equal to 50,000/μL, but levels vary by provider, procedure, and specific patient. Recently, the thrombopoietin receptor agonists avatrombopag and lusutrombopag were studied and found efficacious for increasing platelet count in the outpatient setting for select patients with advanced liver disease who need a procedure.

Original languageEnglish (US)
Pages (from-to)437-451
Number of pages15
JournalClinics in liver disease
Issue number3
StatePublished - Aug 2020


  • Advanced liver disease
  • Cirrhosis
  • Invasive procedures
  • Low platelets
  • TPO receptor agonists
  • Thrombocytopenia
  • Thrombopoietin

ASJC Scopus subject areas

  • Hepatology

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