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

Change in Platelet Count After Transjugular Intrahepatic Portosystemic Shunt Creation: An Advancing Liver Therapeutic Approaches (ALTA) Group Study. Journal of vascular and interventional radiology : JVIR Wong, R. J., Ge, J., Boike, J., German, M., Morelli, G., Spengler, E., Said, A., Desai, A., Couri, T., Paul, S., Frenette, C., Verna, E. C., Goel, A., Fallon, M., Thornburg, B., VanWagner, L., Lai, J. C., Kolli, K. P. 2023

Abstract

To evaluate platelet recovery after transjugular intrahepatic portosystemic shunt (TIPS) creation and patient factors predicting platelet recovery following TIPS creation.Adults with cirrhosis who underwent TIPS creation at 9 US hospitals from 2010-15 were included in this retrospective analysis. Change in platelets from pre- to 4 months post-TIPS was characterized. Logistic regression was used to assess factors associated with top quartile % platelet increase post-TIPS. Subgroup analyses were performed among patients with pre-TIPS platelets =50x109/L.601 patients were included. Median absolute change in platelets was 1x109/L (-26x109/L - 25x109/L). Patients with top quartile % platelet increase had =32% platelet increase. In multivariable analysis, pre-TIPS platelets (OR, 0.97 per 109/L; 95% CI, 0.97-0.98), age (OR, 1.24 per 5y; 95% CI, 1.10-1.39), and pre-TIPS MELD (OR, 1.06 per point; 95% CI, 1.02-1.09) were associated with top quartile (=32%) platelet increase. 94 patients (16%) had platelets =50x109/L pre-TIPS. Median absolute platelet change was 14x109/L (2x109/L-34x109/L). 54% of patients in this subgroup were in the top quartile for platelet increase. In multivariable logistic regression, age (OR, 1.50 per 5y; 95% CI, 1.11-2.02) was the only factor associated with top quartile platelet increase in this subgroup.TIPS creation did not result in significant platelet increase, except among patients with platelet =50x109/L pre-TIPS. Lower pre-TIPS platelets, older age, and higher pre-TIPS MELD 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 pre-TIPS platelets =50x109/L.

View details for DOI 10.1016/j.jvir.2023.04.015

View details for PubMedID 37100199