Hepatic Medicine: Evidence and Research (Apr 2020)
Clinical Implications of Thrombocytopenia for the Cirrhotic Patient
Abstract
Samuel H Sigal,1 Zachary Sherman,2 Arun Jesudian2 1Department of Medicine, Montefiore Medical Center, Bronx, NY, USA; 2Department of Medicine, Weill Cornell Medical Center, New York, NY, USACorrespondence: Samuel H SigalMontefiore Medical Center, Bronx, NY 10467 Tel +1 718 920-6240Fax +1917 398-8466Email [email protected]: Thrombocytopenia is a frequent complication in patients with cirrhosis. As many as 84% of patients with cirrhosis have thrombocytopenia, and it is an independent variable indicative of advanced disease and poor prognosis. Although there is great concern that it may aggravate bleeding during surgical procedures, there is limited evidence to inform decisions regarding the treatment of cirrhotic patients with thrombocytopenia undergoing invasive procedures. Finally, there is evidence that platelets play a significant role in liver regeneration. In this report, the clinical implications of thrombocytopenia in cirrhotic patients are reviewed. The utility of platelet counts in the prognosis of cirrhosis and relationship to complications of advanced liver disease, including portal hypertension, esophageal varices, and hepatocellular carcinoma. The impact of low platelet counts on bleeding complications during invasive procedures is outlined. Finally, the role of platelets and potential adverse impact in liver regeneration is reviewed.Keywords: thrombocytopenia, prognosis, invasive procedures, liver regeneration
