Which of the following therapies is least likely indicated in managing coagulopathy in liver failure?

In the context of managing coagulopathy associated with liver failure, protamine is the therapy least likely indicated. This is largely due to the specific role that protamine plays in the coagulation process. Protamine is primarily used as an antidote to reverse the effects of heparin, an anticoagulant used in various clinical settings. It does not directly address the underlying coagulopathy resulting from liver dysfunction, characterized by impaired synthesis of clotting factors.

In contrast, fresh frozen plasma is often indicated in liver failure cases because it contains clotting factors that the liver has failed to produce adequately. Vitamin K can also be important as it is essential for the synthesis of certain clotting factors that may be deficient in patients with liver disease. Platelet transfusion can be crucial as well, especially if thrombocytopenia is present, as it aims to increase the platelet count and improve hemostasis.

Thus, while fresh frozen plasma, vitamin K, and platelet transfusions are directly related to managing the coagulopathy usually seen in liver failure, protamine does not serve a relevant purpose in this scenario.