Over recent years, clinical practice guidelines have increasingly recognized the limitations of standard coagulation tests, particularly prothrombin time/INR, in predicting procedure-related bleeding, and as a consequence, have generally steered away from recommending pre-procedural blood component prophylaxis based on these parameters.7,8 However, given there is not as yet a validated alternative to assess hemostasis in patients with cirrhosis, there is still uncertainty regarding how best to manage cirrhotic patients in the peri-procedural setting. The gene discussed is F2; the disease is Cirrhosis.