Published online Mar 14, 2014. doi: 10.3748/wjg.v20.i10.2595
Revised: February 9, 2014
Accepted: February 20, 2014
Published online: March 14, 2014
Core tip: The major mechanisms for thrombocytopenia in liver cirrhosis are (1) platelet sequestration in the spleen; and (2) decreased production of thrombopoietin in the liver. For thrombocytopenia that is caused by platelet sequestration in the spleen, partial splenic embolization or laparoscopic splenectomy are effective. Thrombopoietin agonists and targeted agents are alternative tools for noninvasively treating thrombocytopenia due to decreased thrombopoietin production, although their ability to improve thrombocytopenia is under investigation in clinical trials. In this review, we describe the current management of thrombocytopenia due to liver cirrhosis, and we propose the novel concept of using the splenic volume to discern the primary cause of thrombocytopenia due to liver cirrhosis.