title: Partial splenic embolization for thrombocytopenia in liver cirrhosis: predictive factors for platelet increment and risk factors for major complications.
abstract: OBJECTIVE
  To investigate the predictors of platelet increment and risk factors for major complications after partial splenic embolization (PSE) in cirrhosis.
  
  
  METHODS
  Between March 2010 and June 2012, 52 cirrhotic patients with severe thrombocytopenia underwent PSE. Multiple variables were analyzed to identify the correlated factors affecting platelet increment and major complications after PSE.
  
  
  RESULTS
  Linear mixed model analysis indicated the splenic infarction ratio (P < 0.001), non-infarcted splenic volume (P = 0.012), and cholinesterase level (P < 0.001) were significantly associated with the platelet increment after PSE. In receiver operating characteristic (ROC) analysis, the cut-off values of the splenic infarction ratio, and non-infarcted splenic volume for achieving an increment of ≥60.0 × 10(9)/L in platelet counts at 1 year after PSE were 64.3% and 245.8 mL, respectively. After PSE, eight patients developed major complications. Multivariate logistic regression analysis indicated major complications were significantly associated with the infarcted splenic volume (P = 0.024) and Child-Pugh score (P = 0.018). In ROC analysis, the cut-off values of these two factors for discriminating the uncomplicated and complicated were 513.1 mL and 9.5, respectively.
  
  
  CONCLUSIONS
  The platelet increment after PSE depends on the splenic infarction ratio, non-infarcted splenic volume and cholinesterase level. But a large infarcted splenic volume and a high Child-Pugh score may cause complications.
  
  
  CONCLUSIONS
  • The platelet increment after PSE greatly depends on the splenic infarction ratio. • The non-infarcted splenic volume significantly affects the efficacy of PSE. • A high cholinesterase level contributes to the improvement of thrombocytopenia after PSE. • The non-infarcted splenic volume significantly affects the relapse of hypersplenism. • Complications are significantly associated with the infarcted splenic volume and Child-Pugh score.
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, and Interventional Radiology Institute, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. cai020@yeah.net.
authors.forename: Mingyue
authors.initials: M
authors.lastname: Cai
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, and Interventional Radiology Institute, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. huangwensou@sina.com.
authors.forename: Wensou
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Infectious Diseases, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. linchaoshuang@126.com.
authors.forename: Chaoshuang
authors.initials: C
authors.lastname: Lin
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, and Interventional Radiology Institute, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. andyreede@msn.com.
authors.forename: Zhengran
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, and Interventional Radiology Institute, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. qjsyf@163.com.
authors.forename: Jiesheng
authors.initials: J
authors.lastname: Qian
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, and Interventional Radiology Institute, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. gzhuangms@163.com.
authors.forename: Mingsheng
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, and Interventional Radiology Institute, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. cjhx265@163.com.
authors.forename: Zhaolin
authors.initials: Z
authors.lastname: Zeng
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, and Interventional Radiology Institute, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. 263632777@qq.com.
authors.forename: Jingjun
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, and Interventional Radiology Institute, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. shanhong@mail.sysu.edu.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Shan
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, and Interventional Radiology Institute, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong, 510630, China. zhksh010@163.com.
authors.forename: Kangshun
authors.identifier: http://orcid.org/0000-0001-5142-010X
authors.initials: K
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D001792:Blood Platelets; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006971:Hypersplenism / Q000628:therapy*; D007958:Leukocyte Count; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012372:ROC Curve; D012008:Recurrence; D012307:Risk Factors; D013159:Splenic Infarction / Q000473:pathology; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology / Q000628:therapy*; D055815:Young Adult
keywords: Complication; Efficacy; Partial splenic embolization; Predictor; Thrombocytopenia