Therapeutic factors considered according to the preoperative splenic volume for a prolonged increase in platelet count after partial splenic embolization for liver cirrhosis.
OBJECTIVE
Infarcted splenic volume has been identified as the predictive factor for a prolonged increase in platelet count after partial splenic embolization (PSE). However, despite enough infarcted splenic volume, some patients show only a slight increase in platelet counts after PSE because of rapid regrowth of the noninfarcted splenic parenchyma within several months post-PSE. The purpose of this study was to determine the therapeutic factors based on the preoperative splenic volume for a prolonged increase in platelet counts after PSE.


METHODS
In 72 cirrhotic patients with follow-ups longer than 1 year post-PSE, depending on the preoperative splenic volume, the splenic factors associated with a prolonged increase in platelet counts at 1 year after PSE were retrospectively examined.


RESULTS
In 57 patients with preoperative splenic volumes <or=700 ml, the preoperative splenic volume (P = 0.001), infarcted splenic volume (P < 0.001), and splenic infarction ratio (P = 0.001) showed positive correlations with increments in platelet counts at 1 year post-PSE. In 15 patients with preoperative splenic volumes >700 ml, noninfarcted splenic volume (P = 0.003) and splenic infarction ratio (P = 0.002) showed negative and positive correlations with the increment in platelet counts at 1 year post-PSE, respectively.


CONCLUSIONS
In patients with splenic volumes <or=700 ml, the infarcted splenic area significantly affects the prolonged increase in platelet counts post-PSE. In patients with splenic volumes >700 ml, the noninfarcted splenic area is significant.
Hayashi
Hiromitsu
H
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Honjo, Kumamoto, Japan.
Beppu
Toru
T
Okabe
Kazutoshi
K
Masuda
Toshiro
T
Okabe
Hirohisa
H
Ishiko
Takatoshi
T
Baba
Hideo
H
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000097:blood / Q000473:pathology / Q000628:therapy*; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010976:Platelet Count; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D013156:Splenectomy; D013159:Splenic Infarction / Q000097:blood / Q000473:pathology / Q000628:therapy*; D013921:Thrombocytopenia / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*