Real-world efficacy and safety of avatrombopag in Japanese patients with chronic liver disease and severe thrombocytopenia.
Emergingsuggested applicable standard· American Gastroenterological Association, 'AGA Clinical Practice Update on Surgical Risk Assessment and Perioperative Management in Cirrhosis: Expert Review' (Northup PG et al., Clin Gastroenterol Hepatol 2019;17(4):595-606). DOI 10.1016/j.cgh.2018.09.043, PMID 30273751.
No single passage of this standard matched the paper closely enough to quote, so none is shown. The standard is cited above.
Our full summary of this standard
Determine GI surgical clearance based on the specific condition and its activity rather than an automatic sign-off: most stable chronic GI conditions (GERD, IBS, controlled IBD, compensated MASLD, asymptomatic gallstones) may be cleared, while active conditions, cirrhosis, and perioperative drug management require explicit stratification and documentation. For any cirrhotic patient, perform mandatory risk stratification with VOCAL-Penn and Child-Pugh class before clearance; manage variceal prophylaxis per individualized endoscopic and hemodynamic assessment (including NSBB for appropriate candidates) and address rebalanced hemostasis without prophylactic INR correction. Defer elective surgery for active GI bleeding, active IBD flare, recent pancreatitis, or unoptimized anemia, and specify perioperative precautions (stress-dose steroids, biologic hold matrix, GLP-1/SGLT2 holds, aspiration precautions) where indicated.