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Effect of Transjugular Intrahepatic Portosystemic Shunt on Thrombocytopenia Associated with Cirrhosis

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Abstract

Thrombocytopenia is a frequent complication of cirrhosis. Its pathogenesis is not well known, but it has been suggested that splenic congestion induced by portal hypertension may be a major contributory factor. However, the available data regarding the effect of portal decompression either by surgical shunts or transjugular intrahepatic portosystemic shunt (TIPS) on peripheral platelet count in cirrhotics is conflicting. We studied the effects of TIPS on platelet count and mean platelet volume, following a successful TIPS placement. The platelet count had a tendency to decrease but was not statistically significant (120,100 ± 72,100/mm3 before TIPS vs 99,800 ± 51,400/mm3 after TIPS). The mean platelet volume remained essentially unchanged (9.8 ± 1.5 fL before TIPS and 9.9 ± 1.5 fL after TIPS). These results confirm that TIPS has an unpredictable effect on platelet count in cirrhotic patients with thrombocytopenia. The lack of a consistent increase in the peripheral mean platelet volume following TIPS placement suggests that TIPS is unable to significantly enhance the release of platelets sequestered in the splenic compartment in portal hypertension.

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Authors and Affiliations

  1. Nazih Zuhdi Transplantation Institute, Integris-Baptist Medical Center, Oklahoma City, Oklahoma, 73112

    Zeki Karasu, Ahmet Gurakar, Barbara Kerwin, Saadettin Hulagu, Ahmad Jazzar, Robert Mcfadden, Bakr Nour, Anthony Sebastian, Francis Cassidy, Kenneth Stokes & Harlan Wright

  2. Liver Transplant Program, Loyola University Medical Center, Maywood, Illinois, 60153

    Zeki Karasu, Ahmet Gurakar, Barbara Kerwin, Saadettin Hulagu, Ahmad Jazzar, Robert Mcfadden, Bakr Nour, Anthony Sebastian, Francis Cassidy, Kenneth Stokes, David Van Thiel & Harlan Wright

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  1. Zeki Karasu
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  2. Ahmet Gurakar
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  12. Harlan Wright
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Karasu, Z., Gurakar, A., Kerwin, B. et al. Effect of Transjugular Intrahepatic Portosystemic Shunt on Thrombocytopenia Associated with Cirrhosis. Dig Dis Sci 45, 1971–1976 (2000). https://doi.org/10.1023/A:1005694617983

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