This cutoff seems ingrained in clinical practice, which is likely to be in a predominantly non-cirrhotic adult cohort and may relate to in vivo evidence demonstrating that a platelet count of 50–60 × 109/L is required for adequate thrombin generation.23 Still, thrombin generation testing is imperfect in this setting and does not consider the increase in von Willebrand factor and circulating activated platelets seen in cirrhosis, which may counteract the thrombocytopenia, leading to adequate hemostasis.24 This evidence concerns the gene VWF and Thrombocytopenia.