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Hepatic vein waveform and splenomegaly predict improvement of prothrombin time after splenectomy in hepatitis C virus‐related cirrhotic patients
Author(s) -
Kinjo Nao,
Nagao Yoshihiro,
Akahoshi Tomohiko,
Masahiro Kamori,
Hashimoto Naotaka,
Uehara Hideo,
Kawanaka Hirohumi,
Tomikawa Morimasa,
Shirabe Ken,
Hashizume Makoto,
Maehara Yoshihiko
Publication year - 2013
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12040
Subject(s) - medicine , splenectomy , prothrombin time , cirrhosis , bilirubin , gastroenterology , liver function , albumin , surgery , spleen
Aim Whether hepatic function can recover in cirrhotic patients after splenectomy remains controversial. Methods All consecutive Japanese patients with hepatic cirrhosis due to hepatitis C who had undergone elective splenectomy in K yushu U niversity H ospital between J anuary 2008 and D ecember 2009 were included in this retrospective study. Prothrombin time, serum albumin and total bilirubin concentrations were reviewed before and after splenectomy and analyzed to clarify whether splenectomy improves hepatic function in patients with cirrhosis and to determine the factors predictive of improvement in hepatic function. Results Prothrombin time and total serum bilirubin concentration improved after splenectomy; however, serum albumin concentrations did not increase significantly. Twelve months after splenectomy, total serum bilirubin had decreased by over 0.3 mg/ dL in 52.3% of patients and prothrombin time had improved by over 10% in 52.3% of patients. Multiple linear regression analysis identified hepatic vein waveform ( HVWF ) type I ( P = 0.0174) and spleen weight ( P = 0.0394) as independent predictors of improvement in prothrombin time and preoperative total serum bilirubin ( P = 0.0002) as the only independent predictor of decrease in total bilirubin. Total bilirubin and prothrombin time were significantly improved after splenectomy in patients with HVWF type I , however, they were not improved in patients with HVWF type II . Conclusion Prothrombin time and total bilirubin improve in approximately half of cirrhotic patients within a year after splenectomy. HVWF type I and splenomegaly may be predictive factors for improvement in prothrombin time after splenectomy in patients with cirrhosis due to hepatitis C .