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Predictive factors for platelet increase after partial splenic embolization in liver cirrhosis patients
Author(s) -
Hayashi Hiromitsu,
Beppu Toru,
Masuda Toshiro,
Mizumoto Takao,
Takahashi Masashi,
Ishiko Takatoshi,
Takamori Hiroshi,
Kanemitsu Keiichiro,
Hirota Masahiko,
Baba Hideo
Publication year - 2007
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2007.05090.x
Subject(s) - medicine , platelet , mean platelet volume , cirrhosis , gastroenterology , predictive value , embolization , surgery
Background and Aim: Partial splenic embolization (PSE) is often performed for improving thrombocytopenia in cirrhotic patients. We investigated the largely unclear predictive factors for platelet increase at both 1 month and 1 year after PSE. Methods: Aimed at increasing the platelet count, PSE was performed in 42 cirrhotic patients with thrombocytopenia (platelets < 80 × 10 4 /mL) caused by hypersplenism. The clinical data were analyzed to clarify the predictive factors for platelet increase at 1 month ( n = 42) and 1 year ( n = 38) after PSE. Results: The mean splenic infarction ratio was 76.7% ± 11.2%. The platelet count increased to 259% ± 112% and 228% ± 75% of the pretreatment values at 1 month and at 1 year after PSE, respectively. Stepwise multiple linear regression analysis showed that the infarcted splenic volume had a positive independent association with the increase in platelet count at both 1 month ( P = 0.00004) and 1 year ( P = 0.005) after PSE (increase in platelet count (×10 4 /mL): at 1 month = 0.752 + 0.018 × infarcted splenic volume (mL), R 2 = 0.344; at 1 year = 2.19 + 0.01 × infarcted splenic volume (mL), R 2 = 0.203). Receiver operating characteristic analysis yielded a cut‐off value of 388 mL of infarcted splenic volume for achieving an increase of 5.0–8.0 × 10 4 /mL in platelet count at 1 year. Conclusions: PSE can reduce the platelet pool and induce an increase in platelet count. This increase is greatly dependent on the infarcted splenic volume.