title: Therapeutic efficacy of splenectomy is attenuated by necroinflammation of the liver in patients with liver cirrhosis.
abstract: BACKGROUND
  Splenectomy is a therapy for thrombocytopenia caused by hypersplenism with liver cirrhosis. However, the determinant of therapeutic outcomes for this complication has not yet been fully clarified.
  
  
  METHODS
  We studied the laboratory findings of 55 patients who underwent splenectomy for hypersplenism with liver cirrhosis. In addition, we examined the histopathological findings of hepatosplenic tissues of nine patients who underwent hepatectomy for hepatocellular carcinoma and splenectomy for hypersplenism with liver cirrhosis on one stage surgery. The locations of platelets in hepatosplenic tissues were identified by immunohistochemistry. We used monoclonal antibody against CD41.
  
  
  RESULTS
  Among 55 patients, 40 patients had high serum alanine aminotransferase (ALT) level (≧38 IU/l). Blood platelet count after splenectomy of patients with high serum ALT level were significantly lower than those of patients with low serum ALT level (P = 0.02). Histopathologically, platelet area of the liver tissues was positively correlated with hepatic inflammation (P = 0.02). Platelet area of the liver tissues was negatively correlated with blood platelet count after splenectomy (P = 0.03).
  
  
  CONCLUSIONS
  Hepatic inflammation contributes to the accumulation of platelets in liver; therefore, in patients with high serum ALT level, improvement of thrombocytopenia by the elimination of hypersplenism was limited.
authors.affiliation: Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan; Cancer Center, Kurume University Hospital, Kurume, Fukuoka, Japan; Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka, Japan. kondou_reiichirou@kurume-u.ac.jp.
authors.forename: Reiichiro
authors.initials: R
authors.lastname: Kondo
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kage
authors.forename: Toshiro
authors.initials: T
authors.lastname: Ogata
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakashima
authors.forename: Jun
authors.initials: J
authors.lastname: Akiba
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Nomura
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Yano
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006505:Hepatitis / Q000209:etiology* / Q000473:pathology; D006801:Humans; D006971:Hypersplenism / Q000150:complications / Q000601:surgery*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Alanine aminotransferase; Hepatitis C; Hypersplenism; Immunohistochemical analysis; Platelet