The Bottom Line: Transfusions should aim for a hemoglobin level of 7 to 8 g/L with the exception of patients with active ongoing bleeding or with ischemic heart disease. However, overtransfusion should be avoided because theoretically it may induce rebound increases in portal pressure and rebleeding.
Cardenas, Andres. “Management of acute variceal bleeding: emphasis on endoscopic therapy.” Clinics in liver disease 14.2 (2010):251-262.
Variceal bleeding generally occurs late in the natural history of portal hypertension. The initial appearance of varices in those with compensated cirrhosis indicates a progression of the disease from a low-risk state to an intermediate one. Once bleeding occurs, this indicates decompensation and progression to a high risk of death