Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Apr 14:12:49-60.
doi: 10.2147/HMER.S244596. eCollection 2020.

Clinical Implications of Thrombocytopenia for the Cirrhotic Patient

Samuel H Sigal  1 , Zachary Sherman  2 , Arun Jesudian  2
Affiliations
Review

Clinical Implications of Thrombocytopenia for the Cirrhotic Patient

Samuel H Sigal et al. Hepat Med. .

Abstract

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: invasive procedures; liver regeneration; prognosis; thrombocytopenia.

PubMed Disclaimer

Conflict of interest statement

The authors received support from Dova Pharmaceuticals for preparation of this manuscript. The authors report no other conflicts of interest in this work.

References

    1. Hayashi H, Beppu T, Shirabe K, et al. Management of thrombocytopenia due to liver cirrhosis: a review. World J Gastroenterol. 2014;20(10):2595–2605. doi:10.3748/wjg.v20.i10.2595 - DOI - PMC - PubMed
    1. Mitchell O, Feldman DM, Diakow M, et al. The pathophysiology of thrombocytopenia in chronic liver disease. Hep Med. 2016;8:39–50. - PMC - PubMed
    1. Basili S, Raparelli V, Violi F. The coagulopathy of chronic liver disease: is there a causal relationship with bleeding? Yes. Eur J Intern Med. 2010;21(2):62–64. doi:10.1016/j.ejim.2010.01.005 - DOI - PubMed
    1. Giannini EG, Moscatelli A, Brunacci M, et al. Prognostic role of mean platelet volume in patients with cirrhosis. Dig Liver Dis. 2016;48(4):409–413. doi:10.1016/j.dld.2015.10.018 - DOI - PubMed
    1. Chin JL, Hisamuddin SH, O’Sullivan A, et al. Thrombocytopenia, platelet transfusion, and outcome following liver transplantation. Clin Appl Thromb Hemost. 2016;22(4):351–360. doi:10.1177/1076029614559771 - DOI - PubMed