Change in Platelet Count after Transjugular Intrahepatic Portosystemic Shunt Creation: An Advancing Liver Therapeutic Approaches (ALTA) Group Study.

Autor:	Wong RJ; Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California San Francisco, San Francisco, California., Ge J; Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California San Francisco, San Francisco, California., Boike J; Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois., German M; Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Morelli G; Division of Gastroenterology, Hepatology, Department of Medicine, and Nutrition, University of Florida Health, Gainesville, Florida., Spengler E; Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Said A; Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Desai A; Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana., Couri T; Section of Gastroenterology, Hepatology & Nutrition, Department of Medicine, The University of Chicago Pritzker School of Medicine, Chicago, Illinois., Paul S; Section of Gastroenterology, Hepatology & Nutrition, Department of Medicine, The University of Chicago Pritzker School of Medicine, Chicago, Illinois., Frenette C; Department for Organ and Cell Transplantation, The Scripps Clinic, La Jolla, California., Verna EC; Department of Medicine, Center for Liver Disease and Transplantation, Columbia University College of Physicians & Surgeons, New York, New York., Goel A; Department of Internal Medicine, Banner University Medical Center, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona., Fallon M; Department of Internal Medicine, Banner University Medical Center, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona., Thornburg B; Division of Vascular Interventional Radiology, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois., VanWagner L; Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Lai JC; Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California San Francisco, San Francisco, California., Kolli KP; Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California. Electronic address: kanti.kolli@ucsf.edu.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2023 Aug; Vol. 34 (8), pp. 1364-1371. Date of Electronic Publication: 2023 Apr 24.
DOI:	10.1016/j.jvir.2023.04.015
Abstrakt:	Purpose: To evaluate recovery of platelet count after transjugular intrahepatic portosystemic shunt (TIPS) creation and patient factors predicting platelet recovery after TIPS creation. Materials and Methods: Adults with cirrhosis who underwent TIPS creation at 9 U.S. hospitals from 2010 to 2015 were included in this retrospective analysis. Change in platelets from before TIPS to 4 months after TIPS creation was characterized. Logistic regression was used to assess factors associated with top quartile percentage platelet increase after TIPS. Subgroup analyses were performed among patients with a pre-TIPS platelet count of ≤50 ×10 9 /L. Results: A total of 601 patients were included. The median absolute change in platelets was 1 × 10 9 /L (-26 × 10 9 /L to 25 × 10 9 /L). Patients with top quartile percent platelet increase experienced ≥32% platelet increase. In multivariable analysis, pre-TIPS platelet counts (odds ratio [OR], 0.97 per 10 9 /L; 95% CI, 0.97-0.98), age (OR, 1.24 per 5 years; 95% CI, 1.10-1.39), and pre-TIPS model for end-stage liver disease (MELD) scores (OR, 1.06 per point; 95% CI, 1.02-1.09) were associated with top quartile (≥32%) platelet increase. Ninety-four (16%) patients had a platelet count of ≤50 × 10 9 /L before TIPS. The median absolute platelet change was 14 × 10 9 /L (2 × 10 9 /L to 34 × 10 9 /L). Fifty-four percent of patients in this subgroup were in the top quartile for platelet increase. In multivariable logistic regression, age (OR, 1.50 per 5 years; 95% CI, 1.11-2.02) was the only factor associated with top quartile platelet increase in this subgroup. Conclusions: TIPS creation did not result in significant platelet increase, except among patients with a platelet count of ≤50 × 10 9 /L before TIPS. Lower pre-TIPS platelet counts, older age, and higher pre-TIPS MELD scores were associated with top quartile (≥32%) platelet increase in the entire cohort, whereas only older age was associated with this outcome in the patient subset with a pre-TIPS platelet count of ≤50 × 10 9 /L. (Copyright © 2023. Published by Elsevier Inc.)
Databáze:	MEDLINE
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