Before liver biopsy we routinely do PT & platelet count. But now a days we are doing also APTT & frequently it is found prolonged. Some times FFP infusion failed to correct it. What measures can then be taken before biopsy?
First, find out the cause of prolong APTT and treat accordingly then do liver biopsy. In case of early stage liver failure, APTT is unaffected but end stage it is prolong.So FFP, Cryoprecipitate or Factor Concentrate which is need may be use before biopsy.
Although in Vit. K defficiency both PT and APTT are usually abnormal, sometimes infusion of Vit. K may be helpfull if plasma is not correcting abnormal APTT. Of course it would be best to find the reason of prolonged APTT (lupus anticoagulant?) first, but if you need a quick effect, consider...
Luis Rodrigo, Thanks but it didn't work even after two infusion. After seeing low fibrinogen We infused Cryoprecipitate which also failed to correct APTT completely.
APTT may not be associated with the risk of bleeding after liver biopsy. Could you please show you cut-off value of APTT to stop liver biopsy?
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