title: Coated transjugular intrahepatic portosystemic shunt does not improve thrombocytopenia in patients with liver cirrhosis.
abstract: OBJECTIVE
  Thrombocytopenia is a common complication of chronic liver disease. The theory of portal decompression to improve thrombocytopenia due to hypersplenism has led to the study of transjugular intrahepatic portosystemic shunt (TIPS) as a potential therapy. However, there is a paucity of data and results have been conflicting. The aim of this study was to determine whether platelet counts improved in cirrhotic patients after placement of the new polytetrafluoroethylene (PTFE)-coated TIPS, developed in 2004.
  
  
  METHODS
  This is a retrospective cohort study of 68 patients with chronic liver disease who underwent a TIPS procedure. One-hundred twenty controls who did not undergo a TIPS procedure were matched on average for age, sex, race, model for end-stage liver disease (MELD) score, and etiology of liver disease. Platelet and hemoglobin counts were recorded during the month prior to the TIPS procedure (baseline) and over the following 12-14 months or until transplanted or death.
  
  
  RESULTS
  While platelet counts improved during the first 3 months after TIPS with a mean increase of 11.25 × 103/μL (p = 0.064), they returned to baseline (pre-TIPS) with mean platelets of 91.31 × 103 μL by 12-14 months in comparison with a mild decrease of 10.2 × 103 μL in platelet counts in the control group from 100.4 × 103 μL to 90.2 × 103 (p = 0.119). There was also no significant correlation between platelet counts and etiology of liver disease, age, race, gender, or MELD score. Hemoglobin counts were found to have a small increase of 0.657 g/dL over the 12-14 month course in the TIPS group, which was statistically significant (p = 0.003).
  
  
  CONCLUSIONS
  There does not appear to be a significant improvement in thrombocytopenia in cirrhotic patients after TIPS placement, despite advances in TIPS stents. However, there may be a mild improvement in anemia after TIPS implantation.
authors.affiliation: Department of Medical Education, Banner Good Samaritan Medical Center, 1111 E. McDowell Rd, Phoenix, AZ 85006, USA. EBarney@bannerhealth.com
authors.forename: Elise J
authors.initials: EJ
authors.lastname: Barney
authors.forename: Ester C
authors.initials: EC
authors.lastname: Little
authors.forename: Richard D
authors.initials: RD
authors.lastname: Gerkin
authors.forename: Alberto X
authors.initials: AX
authors.lastname: Ramos
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kahn
authors.forename: Mark
authors.initials: M
authors.lastname: Wong
authors.forename: Geetha
authors.initials: G
authors.lastname: Kolli
authors.forename: Richard
authors.initials: R
authors.lastname: Manch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012189:Retrospective Studies; D015607:Stents; D013921:Thrombocytopenia / Q000209:etiology*; D055815:Young Adult
chemical_list: D011138:Polytetrafluoroethylene