Evaluation of the effect of partial splenic embolization on platelet values for liver cirrhosis patients with thrombocytopenia.
OBJECTIVE
To investigate the effect of partial splenic embolization (PSE) on platelet values in liver cirrhosis patients with thrombocytopenia and to determine the effective embolization area for platelet values improvement.


METHODS
Blood parameters and liver function indicators were measured on 10 liver cirrhosis patients (6 in Child-Pugh grade A and 4 in grade B) with thrombocytopenia (platelet values < 80 x 10(3)/microL) before embolization. Computed tomography scan was also needed in advance to acquire the splenic baseline. After 2 to 3 d, angiography and splenic embolization were performed. A second computed tomography scan was made to confirm the embolization area after 2 to 3 wk of embolization. The blood parameters of patients were also examined biweekly during the 1 year follow-up period.


RESULTS
According to the computed tomography images after partial splenic embolization, we divided all patients into two groups: low (< 30%), and high (> or = 30%) embolization area groups. The platelet values were increased by 3 times compared to baseline levels after 2 wk of embolization in high embolization area group. In addition, there were significant differences in platelet values between low and high embolization area groups. GPT values decreased significantly in all patients after 2 wk of embolization. The improvement in platelet and GPT values still persisted until 1 year after PSE. In addition, 3 of 4 (75%) Child-Pugh grade B patients progressed to grade A after 2 mo of PSE. The complication rate in < 30% and > or = 30% embolization area groups was 50% and 100%, respectively.


CONCLUSIONS
Partial splenic embolization is an effective method to improve platelet values and GPT values in liver cirrhosis patients with thrombocytopenia and the > or = 30% embolization area is meaningful for platelet values improvement. The relationship between the complication rate and embolization area needs further studies.
Lee
Chi-Ming
CM
Department of Diagnostic Radiology, Taipei Medical University Hospital, 110, Taipei, Taiwan, China.
Leung
Ting-Kai
TK
Wang
Hung-Jung
HJ
Lee
Wei-Hsing
WH
Shen
Li-Kuo
LK
Liu
Jean-Dean
JD
Chang
Chun-Chao
CC
Chen
Ya-Yen
YY
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000628:therapy*; D008875:Middle Aged; D010976:Platelet Count; D013157:Splenic Artery; D013921:Thrombocytopenia / Q000628:therapy*
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase