Don’t routinely transfuse fresh frozen plasma and platelets prior to abdominal paracentesis or endoscopic variceal band ligation.
Routine tests of coagulation do not reflect bleeding risk in patients with cirrhosis and bleeding complications of these procedures are rare.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
The American Association for the Study of Liver Diseases (AASLD) established a Choosing Wisely® Task Force in December 2013 to develop its list of recommendations. Members of this group were selected from the AASLD Practice Guidelines Committee to broadly represent varying practice settings and subspecialty expertise within the field of hepatology. Hepatologists with methodological experience in evidence-based medicine were also included. The working group solicited recommendations from the entire AASLD membership that should be considered for inclusion in the list of “Five Things Physicians and Patients Should Question”. These recommendations were then rated based upon judgments related to harm, benefit and excess resource utilization. Based on working group voting and literature review, a total of 10 suggestions were identified with subsequent voting by the working group to generate the final Top Five recommendations. These recommendations were submitted and approved by AASLD Governing Board.
AASLD’s disclosure and conflict of interest policy can be found at www.aasld.org.
Runyon BA; AASLD. Introduction to the revised American Association for the Study of Liver Diseases Practice Guideline management of adult patients with ascites due to cirrhosis 2012. Hepatology. 2013 Apr;57(4):1651–3.
Tripodi A, Mannucci PM. The coagulopathy of chronic liver disease. N Engl J Med. 2011 Jul 14;365(2):147–56.