No transfusion is needed before central venous catheter insertion. This patient has modest coagulopathy and thrombocytopenia resulting from hepatitis C–related liver disease. Previous retrospective studies have shown that central venous catheter insertion is safe in patients with a prolonged prothrombin time and INR, including those with liver disease. In a prospective audit of 580 internal jugular and subclavian vein cannulations in patients with chronic liver disease and an INR of 1.5 or greater, only one major vascular complication was noted.

Although his fibrinogen level is slightly low, cryoprecipitate is typically reserved for patients with clinically significant bleeding and a fibrinogen level less than 100 mg/dL (1.0 g/L). Cryprecipitate in the prophylaxis of bleeding for patients with low fibrinogen levels undergoing procedures has not been evaluated.

Numerous studies have shown that fresh frozen plasma (FFP) is overutilized in nonbleeding patients with mild coagulopathies, which is a significant problem given the risks associated with FFP use, including transfusion-related acute lung injury, transfusion-transmitted infection, transfusion-associated circulatory overload, allergic reactions, and hemolysis. The role of FFP in the prevention of bleeding complications for nonbleeding patients undergoing procedures is unclear. However, it is known that FFP is ineffective at correcting a minimally elevated INR (<1.85).

Most procedures and surgeries can be safely performed with a platelet count of at least 50,000/µL (50 × 10⁹/L), although a platelet count of at least 100,000/µL (100 × 10⁹/L) is recommended for neurosurgical intervention. Thus, a platelet transfusion is not indicated for this patient.