Thrombocyte Aggregation Inhibitors Are Important

In the review article entitled “The indications for liver biopsy” (1), the recommendations for coagulation say: “For safety, the platelet count should be above 50/nL, and the Quick value over 50% (e4).” Unfortunately the authors do not make any mention of platelet aggregation inhibitors.

In context of an expert report, the case of a patient was worked up in which, after a biopsy of a hepatic nodule with continued intake of acetylsalicylic acid, a massive hemorrhage occurred at the puncture site. The insurers declared non-liability because no guidelines or binding regulations exist in this scenario. The German-language literature does, however, provide recommendations according to which platelet aggregation inhibitors should be stopped in good time before a liver biopsy is undertaken (2, 3).

It would therefore be of general interest to find out where the authors stand with regard to this question.

DOI: 10.3238/arztebl.2013.0059a

Prof. Dr. med. Georg Schultze

Villingen-Schwenningen

GSchultze.VS@t-online.de.

Conflict of interest statement

The author has received honoraria for consultancy services from the medical service of the health insurance companies in Germany (Medizinischer Dienst der Krankenversicherung, MDK) Saarland.