Predictive factors for platelet increase after partial splenic embolization in liver cirrhosis patients

Abstract

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. Aimed at increasing the platelet count, PSE was performed in 42 cirrhotic patients with thrombocytopenia (platelets < 80 x 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. 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 (x10(4)/mL): at 1 month = 0.752 + 0.018 x infarcted splenic volume (mL), R(2) = 0.344; at 1 year = 2.19 + 0.01 x 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 x 10(4)/mL in platelet count at 1 year. PSE can reduce the platelet pool and induce an increase in platelet count. This increase is greatly dependent on the infarcted splenic volume.