Ultrasonography (Seoul, Korea) · 2025
Effect of prophylactic platelet transfusion on bleeding risk in patients with cirrhosis and thrombocytopenia undergoing ultrasound-guided liver biopsy.
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Jang Hyeon Ji, Park Hyo Jung, Choi Jonggi, Heo Subin, Choi Se Jin, Kim So Yeon, Lee Seung Soo
Аннотация
PURPOSE: The utility of platelet transfusion for preventing post-biopsy bleeding in patients with cirrhosis and thrombocytopenia remains a topic of debate. This study investigated whether prophylactic transfusion reduces this risk.
METHODS: This retrospective study included patients with cirrhosis and thrombocytopenia who underwent ultrasound-guided percutaneous liver biopsy (March 2018-October 2024) at a tertiary institution. Bleeding events were defined as major (requiring intervention or resulting in death) or minor (non-interventional hematoma). Pre- and post-transfusion platelet counts were compared, and bleeding incidence was examined by transfusion status. Logistic regression was used to identify factors associated with bleeding events. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to assess bleeding incidence by transfusion status.
RESULTS: This study analyzed 526 biopsies from 497 patients (mean age, 62.1±10.6 years; 365 men [73.4%]), of whom 42 (8.0%) received prophylactic platelet transfusion. While platelet counts increased after transfusion (from 54.5×109/L to 72.5×109/L, P<0.001), no significant difference was observed in bleeding incidence between the transfused and non-transfused groups (31.0% vs. 20.9%, P=0.128). Multivariate analysis indicated that platelet transfusion was not associated with all bleeding (odds ratio [OR], 1.318; P=0.449) or major bleeding (OR, 1.754; P=0.420). PSM and IPTW analyses similarly revealed no association between transfusion and all bleeding (PSM: OR, 1.173; P=0.739; IPTW: OR, 0.907; P=0.807) or major bleeding (PSM: OR, 0.658, P=0.716; IPTW: OR, 0.863; P=0.876).
CONCLUSION: Prophylactic platelet transfusion may not provide a universal benefit in patients with cirrhosis and thrombocytopenia, warranting a more tailored approach based on individual risk assessment.
METHODS: This retrospective study included patients with cirrhosis and thrombocytopenia who underwent ultrasound-guided percutaneous liver biopsy (March 2018-October 2024) at a tertiary institution. Bleeding events were defined as major (requiring intervention or resulting in death) or minor (non-interventional hematoma). Pre- and post-transfusion platelet counts were compared, and bleeding incidence was examined by transfusion status. Logistic regression was used to identify factors associated with bleeding events. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to assess bleeding incidence by transfusion status.
RESULTS: This study analyzed 526 biopsies from 497 patients (mean age, 62.1±10.6 years; 365 men [73.4%]), of whom 42 (8.0%) received prophylactic platelet transfusion. While platelet counts increased after transfusion (from 54.5×109/L to 72.5×109/L, P<0.001), no significant difference was observed in bleeding incidence between the transfused and non-transfused groups (31.0% vs. 20.9%, P=0.128). Multivariate analysis indicated that platelet transfusion was not associated with all bleeding (odds ratio [OR], 1.318; P=0.449) or major bleeding (OR, 1.754; P=0.420). PSM and IPTW analyses similarly revealed no association between transfusion and all bleeding (PSM: OR, 1.173; P=0.739; IPTW: OR, 0.907; P=0.807) or major bleeding (PSM: OR, 0.658, P=0.716; IPTW: OR, 0.863; P=0.876).
CONCLUSION: Prophylactic platelet transfusion may not provide a universal benefit in patients with cirrhosis and thrombocytopenia, warranting a more tailored approach based on individual risk assessment.