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World J Gastroenterol. Jan 28, 2007; 13(4): 619-622
Published online Jan 28, 2007. doi: 10.3748/wjg.v13.i4.619
Evaluation of the effect of partial splenic embolization on platelet values for liver cirrhosis patients with thrombocytopenia
Chi-Ming Lee, Ting-Kai Leung, Hung-Jung Wang, Wei-Hsing Lee, Li-Kuo Shen, Jean-Dean Liu, Chun-Chao Chang, Ya-Yen Chen
Chi-Ming Lee, Ting-Kai Leung, Hung-Jung Wang, Wei-Hsing Lee, Li-Kuo Shen, Ya-Yen Chen, Department of Diagnostic Radiology, Taipei Medical University Hospital, Taipei, Taiwan, China
Chi-Ming Lee, Ting-Kai Leung, Department of Medicine, Taipei Medical University, Taipei, Taiwan, China
Jean-Dean Liu, Chun-Chao Chang, Division of Gastroenterology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, China
Author contributions: All authors contributed equally to the work.
Supported by the Min-Sheng Healthcare, No.93MSH-TMU-12
Correspondence to: Hung-Jung Wang, 252, Wu Hsing Street, 110, Taipei, Taiwan, China. yayen0220@yahoo.com.tw
Telephone: +886-2-27372181-1131 Fax: +886-2-23780943
Received: November 3, 2006
Revised: July 25, 2006
Accepted: December 25, 2006
Published online: January 28, 2007
Abstract

AIM: To investigate the effect of partial splenic embolization (PSE) on platelet values in liver cirrhosis patients with thrombocytopenia and to determine the effective embolization area for platelet values improvement.

METHODS: Blood parameters and liver function indicators were measured on 10 liver cirrhosis patients (6 in Child-Pugh grade A and 4 in grade B) with thrombocytopenia (platelet values < 80 × 103/μL) before embolization. Computed tomography scan was also needed in advance to acquire the splenic baseline. After 2 to 3 d, angiography and splenic embolization were performed. A second computed tomography scan was made to confirm the embolization area after 2 to 3 wk of embolization. The blood parameters of patients were also examined biweekly during the 1 year follow-up period.

RESULTS: According to the computed tomography images after partial splenic embolization, we divided all patients into two groups: low (< 30%), and high (≥ 30%) embolization area groups. The platelet values were increased by 3 times compared to baseline levels after 2 wk of embolization in high embolization area group. In addition, there were significant differences in platelet values between low and high embolization area groups. GPT values decreased significantly in all patients after 2 wk of embolization. The improvement in platelet and GPT values still persisted until 1 year after PSE. In addition, 3 of 4 (75%) Child-Pugh grade B patients progressed to grade A after 2 mo of PSE. The complication rate in < 30% and ≥ 30% embolization area groups was 50% and 100%, respectively.

CONCLUSION: Partial splenic embolization is an effective method to improve platelet values and GPT values in liver cirrhosis patients with thrombocytopenia and the ≥ 30% embolization area is meaningful for platelet values improvement. The relationship between the complication rate and embolization area needs further studies.

Keywords: Partial splenic embolization, Liver cirrhosis, Thrombocytopenia