The risk factors of persistent thrombocytopenia and splenomegaly after liver transplantation.
Summary of "The risk factors of persistent thrombocytopenia and splenomegaly after liver transplantation."
PURPOSE:
The occurrence of thrombocytopenia in the perioperative period after liver transplantation (LT) in patients with portal hypertension is not uncommon. In most cases, thrombocytopenia in the early period after LT recovers with the restoration of the graft hepatic function. In contrast, the recovery of pre-transplant thrombocytopenia differs among patients, and some patients experience persistent thrombocytopenia and splenomegaly even several years after LT.
METHODS:
We retrospectively reviewed the clinical records of 38 liver transplant patients who had at least a 1-year follow-up in our institute. The serial platelet counts and the spleen volumes estimated by the CT scans were obtained before LT and at 1 month, 1 year, and 3 years after LT. In cases with persistent thrombocytopenia (less than 100,000/mul beyond 1 year after LT) and splenomegaly after LT, the associated clinical factors were reviewed.
RESULTS:
The platelet counts increased and the spleen volumes decreased continuously in most cases after LT. However, six patients (15.8%) were categorized as persistent thrombocytopenia. The spleen volumes of these six patients decreased more slowly after LT, and, in some cases, showed even re-increased volumes. The factors such as the age at LT, GRWR, the existence of hepatopulmonary syndrome, and the existence of biliary complication after LT were associated with persistent thrombocytopenia after LT.
CONCLUSIONS:
The evaluation of the pre-transplant spleen volumes and the platelet counts before LT thus makes it possible to predict the persistent thrombocytopenia after LT.
Affiliation
Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan, matsuura@pedsurg.med.kyushu-u.ac.jp.
Journal Details
This article was published in the following journal.
Name: Pediatric surgery international
ISSN: 1437-9813
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20652708
- DOI: http://dx.doi.org/10.1007/s00383-010-2660-z
Medical and Biotech [MESH] Definitions
Felty's Syndrome
A combination of rheumatoid arthritis, splenomegaly, leukopenia, pigmented spots on lower extremities, and other evidence of hypersplenism (anemia and thrombocytopenia). (From Dorland, 27th ed)
Causality
The relating of causes to the effects they produce. Causes are termed necessary when they must always precede an effect and sufficient when they initiate or produce an effect. Any of several factors may be associated with the potential disease causation or outcome, including predisposing factors, enabling factors, precipitating factors, reinforcing factors, and risk factors.
End Stage Liver Disease
Final stage of a liver disease when the liver failure is irreversible and LIVER TRANSPLANTATION is needed.
Liver Transplantation
The transference of a part of or an entire liver from one human or animal to another.
Hepatic Insufficiency
Conditions in which the LIVER functions fall below the normal ranges. Severe hepatic insufficiency may cause LIVER FAILURE or DEATH. Treatment may include LIVER TRANSPLANTATION.
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