EASL Campus

A 48-year-old man with alcohol-related liver cirrhosis is seen on the liver ward. The resident has heard he was initially admitted a week back to another hospital for a variceal bleed but is now stable, although he has new ascites and his last INR is 2.0, and a platelet count 52 x10⁹/L. The resident is concerned that he should optimise these parameters.

Which of the following are correct statements:

A. The INR should be corrected with Vitamin K to reduce risk of spontaneous bleeding

B. If the platelets are <50 x10^9/L, platelet pools should be given before a planned repeat variceal ligation procedure

C. If the patient has active portal hypertensive gastropathy related bleeding, correction of the coagulation profile is indicated, in addition to portal pressure lowering agents

D. The man needs a therapeutic paracentesis and given this, there is a role for tranexamic acid to reduce post-procedural bleeding

E. None of these statements are correct

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