Bleeding after liver biopsy: Remarkably infrequent but potentially serious and unfortunately unpredictable by extensive clinical laboratory analyses—Take a closer look at the biopsy?

Abstract

Severe and sometimes intractable bleeding among liver disease patients remains a well‐known clinical problem that is even more problematic if the bleeding is iatrogenic and related to a clinical procedure. Because many such patients have a prolonged prothrombin time (PT) and hence an abnormal PT‐derived international normalized ratio (INR), the fallacious relationship between elevated INR and bleeding risk was perpetuated for decades. This promoted the creation of a spurious PT‐derived INR cut‐off in the false belief that this would enhance safety among liver disease patients undergoing invasive procedures.