title: Thrombopoietic cytokines and reversal of thrombocytopenia after liver transplantation.
abstract: OBJECTIVE
  Thrombopoietin (TPO), the key regulator of platelet production, is mainly produced by the liver and reduced expression of TPO could cause thrombocytopenia in liver cirrhosis. Reversal of thrombocytopenia by orthotopic liver transplantation seems to be mediated through an increase in TPO plasma levels after transplantation, but other cytokines with thrombopoietic activity could augment the actions of TPO on post transplant platelet recovery.
  
  
  METHODS
  Measurement of thrombopoietic cytokines before and for 14 days post liver transplantation in a cohort of thrombocytopenic liver transplant patients.
  
  
  METHODS
  TPO, interleukin-3 (IL-3), IL-6, and IL-11 plasma levels as well as peripheral platelet count were analysed in thrombocytopenic patients with liver disease undergoing orthotopic liver transplantation (17 patients) and followed for 14 days after the intervention.
  
  
  RESULTS
  Before liver transplantation, TPO plasma levels were undetectable and IL-3, IL-6, and IL-11 levels were normal. Sixteen out of 17 patients showed a significant rise of TPO levels within 2 days after transplantation, with a peak between days 4 and 6, while IL-3 and IL-6 levels did not show a significant rise. IL-11 levels remained normal. Platelet counts were significantly higher than pretransplantation levels by day 14 post transplantation.
  
  
  CONCLUSIONS
  Restitution of normal TPO production by liver replacement seems to be of key importance for reversal of thrombocytopenia in liver disease. The early acting thrombopoietic factor IL-3 and the late acting factors IL-6 and IL-11 do not play a major role for recovery of peripheral platelet count after orthotopic liver transplantation.
authors: Department of Gastroenterology and Hepatology, University of Vienna, Austria. m.peck@magnet.at
authors: M
authors: M
authors: Peck-Radosavljevic
authors: J
authors: J
authors: Zacherl
authors: M
authors: M
authors: Wichlas
authors: P
authors: P
authors: Sims
authors: Y G
authors: YG
authors: Meng
authors: S
authors: S
authors: Panzer
authors: E
authors: E
authors: Lipinski
authors: R
authors: R
authors: Steininger
authors: F
authors: F
authors: Mühlbacher
authors: J
authors: J
authors: Pidlich
authors: A
authors: A
authors: Gangl
mesh_terms: D000704:Analysis of Variance; D001792:Blood Platelets / Q000502:physiology; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D017370:Interleukin-11 / Q000097:blood*; D007377:Interleukin-3 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008099:Liver / Q000378:metabolism; D008103:Liver Cirrhosis / Q000097:blood / Q000601:surgery; D017093:Liver Failure / Q000601:surgery; D016031:Liver Transplantation; D010976:Platelet Count; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000032:analysis; D019038:Platelet Glycoprotein GPIb-IX Complex / Q000032:analysis; D013921:Thrombocytopenia / Q000628:therapy*; D013926:Thrombopoietin / Q000096:biosynthesis / Q000097:blood*
chemical_list: D017370:Interleukin-11; D007377:Interleukin-3; D015850:Interleukin-6; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D019038:Platelet Glycoprotein GPIb-IX Complex; D013926:Thrombopoietin