Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures

Background: Second-generation thrombopoietin receptor agonists (TPO-RAs) are emerging as the new standard for managing thrombocytopenia (TCP) in patients with chronic liver diseases (CLDs) undergoing scheduled procedures. However, practical guidance for their routine use in CLD patients undergoing s...

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Autores principales:	Robert Flisiak, Krasimir Antonov, Pavel Drastich, Peter Jarcuska, Marina Maevskaya, Mihály Makara, Željko Puljiz, Borut Štabuc, Anca Trifan
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	chronic liver disease avatrombopag thrombocytopenia surgical procedures thrombopoietin receptor agonists platelet transfusion Medicine R
Acceso en línea:	https://doaj.org/article/9b8263fcddf5497b91835f71ec4c5163
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spelling	oai:doaj.org-article:9b8263fcddf5497b91835f71ec4c51632021-11-25T18:02:37ZPractice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures10.3390/jcm102254192077-0383https://doaj.org/article/9b8263fcddf5497b91835f71ec4c51632021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5419https://doaj.org/toc/2077-0383Background: Second-generation thrombopoietin receptor agonists (TPO-RAs) are emerging as the new standard for managing thrombocytopenia (TCP) in patients with chronic liver diseases (CLDs) undergoing scheduled procedures. However, practical guidance for their routine use in CLD patients undergoing specific invasive procedures is lacking. Methods: These practice guidelines were developed by the Initiative Group for Central European Hepatologic Collaboration (CEHC), composed of nine hepatologist/gastroenterologist experts from Central Europe. Using an adapted Delphi process, the CEHC group selected ten invasive procedures most relevant to the hepatology/gastroenterology setting in the region. Consensus recommendations for each invasive procedure are reported as a final percentage of expert panel responses. Results: A consensus was agreed that TPO-RAs should be considered for raising platelet count in CLD patients undergoing scheduled abdominal surgery, high-bleeding risk dentistry, endoscopic polypectomy, endoscopic variceal ligation, liver biopsy, liver surgery, liver transplantation and percutaneous ablation, but it was also agreed that they are less beneficial or not necessary for endoscopy without intervention and paracentesis. Conclusions: Using a modified Delphi method, experts reached an agreement for TCP management in CLD patients undergoing ten invasive procedures. These practice guidelines may help with decision making and patient management in areas where clinical evidence is absent or limited.Robert FlisiakKrasimir AntonovPavel DrastichPeter JarcuskaMarina MaevskayaMihály MakaraŽeljko PuljizBorut ŠtabucAnca TrifanMDPI AGarticlechronic liver diseaseavatrombopagthrombocytopeniasurgical proceduresthrombopoietin receptor agonistsplatelet transfusionMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5419, p 5419 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic liver disease avatrombopag thrombocytopenia surgical procedures thrombopoietin receptor agonists platelet transfusion Medicine R
spellingShingle	chronic liver disease avatrombopag thrombocytopenia surgical procedures thrombopoietin receptor agonists platelet transfusion Medicine R Robert Flisiak Krasimir Antonov Pavel Drastich Peter Jarcuska Marina Maevskaya Mihály Makara Željko Puljiz Borut Štabuc Anca Trifan Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures
description	Background: Second-generation thrombopoietin receptor agonists (TPO-RAs) are emerging as the new standard for managing thrombocytopenia (TCP) in patients with chronic liver diseases (CLDs) undergoing scheduled procedures. However, practical guidance for their routine use in CLD patients undergoing specific invasive procedures is lacking. Methods: These practice guidelines were developed by the Initiative Group for Central European Hepatologic Collaboration (CEHC), composed of nine hepatologist/gastroenterologist experts from Central Europe. Using an adapted Delphi process, the CEHC group selected ten invasive procedures most relevant to the hepatology/gastroenterology setting in the region. Consensus recommendations for each invasive procedure are reported as a final percentage of expert panel responses. Results: A consensus was agreed that TPO-RAs should be considered for raising platelet count in CLD patients undergoing scheduled abdominal surgery, high-bleeding risk dentistry, endoscopic polypectomy, endoscopic variceal ligation, liver biopsy, liver surgery, liver transplantation and percutaneous ablation, but it was also agreed that they are less beneficial or not necessary for endoscopy without intervention and paracentesis. Conclusions: Using a modified Delphi method, experts reached an agreement for TCP management in CLD patients undergoing ten invasive procedures. These practice guidelines may help with decision making and patient management in areas where clinical evidence is absent or limited.
format	article
author	Robert Flisiak Krasimir Antonov Pavel Drastich Peter Jarcuska Marina Maevskaya Mihály Makara Željko Puljiz Borut Štabuc Anca Trifan
author_facet	Robert Flisiak Krasimir Antonov Pavel Drastich Peter Jarcuska Marina Maevskaya Mihály Makara Željko Puljiz Borut Štabuc Anca Trifan
author_sort	Robert Flisiak
title	Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures
title_short	Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures
title_full	Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures
title_fullStr	Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures
title_full_unstemmed	Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures
title_sort	practice guidelines of the central european hepatologic collaboration (cehc) on the use of thrombopoietin receptor agonists in patients with chronic liver disease undergoing invasive procedures
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/9b8263fcddf5497b91835f71ec4c5163
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Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures

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