Thrombopoietin concentrations are low in patients with cirrhosis and thrombocytopenia and are restored after orthotopic liver transplantation

BACKGROUND Thrombocytopenia in cirrhotic patients may be due to deficient production of thrombopoietin. AIMS To determine the relation between thrombopoietin and thrombocytopenia in cirrhotic patients before and after orthotopic liver transplantation. METHODS Thrombopoietin concentrations and platel...

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Bibliographic Details
Published in:Gut 1999-05, Vol.44 (5), p.754-758
Main Authors: Goulis, J, Chau, T N, Jordan, S, Mehta, A B, Watkinson, A, Rolles, K, Burroughs, A K
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Biopsy
Bone marrow
Cholangitis
cirrhosis
Digestive system
Female
Hepatitis
Humans
Investigative techniques, diagnostic techniques (general aspects)
Liver cirrhosis
Liver Cirrhosis - blood
Liver Cirrhosis - complications
Liver Cirrhosis - surgery
Liver Disease
Liver diseases
Liver Transplantation
Male
Medical sciences
Middle Aged
Monoclonal antibodies
orthotopic liver transplantation
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Platelet Count
platelets
Postoperative Period
Spleen
Spleen - pathology
Thrombocytopenia
Thrombocytopenia - blood
Thrombocytopenia - etiology
thrombopoietin
Thrombopoietin - blood
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Summary:BACKGROUND Thrombocytopenia in cirrhotic patients may be due to deficient production of thrombopoietin. AIMS To determine the relation between thrombopoietin and thrombocytopenia in cirrhotic patients before and after orthotopic liver transplantation. METHODS Thrombopoietin concentrations and platelet counts were measured in 43 cirrhotic patients and 21 normal controls and serially for 14 days after transplantation in 23/43 patients. RESULTS 27 of the 43 patients had thrombocytopenia (platelet count less than 120 × 109/l; group 1) whereas 16 patients had normal platelet count (group 2). Thrombopoietin concentrations were lower in group 1 than in group 2 (92.5 (20.3–286.3) v 226.6 (30.1–848.3) pg/ml, p=0.003) and normal controls (92.5 (20.3–286.3)v 158.3 (22.5–232.9) pg/ml, p=0.028). Post-transplantation thrombopoietin concentrations increased with a peak at day 5. The rise was significant in patients with low pretransplantation platelet count (89.1 (21.29–247.6) to 545.1 (66.2–2569) pg/ml; n=16, p=0.001) but not in those with normal platelet count (262.8 (30.1–848.3) to 315.1 (114–954.6) pg/ml; n=7, p=0.47). No correlation was found pretransplantation between spleen volume and platelet count (r=−0.11, p=0.6) or thrombopoietin concentrations (r=−0.04, p=0.8). However, pretransplantation thrombopoietin concentrations correlated with platelet count (r=0.47, p=0.0015), whereas an inverse correlation was found between peak thrombopoietin concentrations and nadir platelet count (r=−0.41 p=0.049) post-transplantation. CONCLUSIONS Inadequate thrombopoietin production may contribute to cirrhotic thrombocytopenia. Thrombopoietin production is restored after liver transplantation leading to the resolution of thrombocytopenia.
ISSN:0017-5749
1468-3288
1458-3288
DOI:10.1136/gut.44.5.754