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

Overview

Journal J Vasc Interv Radiol

Specialties Cardiology & Vascular Diseases
Radiology

Date 2023 Apr 26

PMID 37100199

Authors

Randi J Wong

Jin Ge

Justin Boike

Margarita German

Giuseppe Morelli

Erin Spengler

Adnan Said

Archita Desai

Thomas Couri

Sonali Paul

Catherine Frenette

Elizabeth C Verna

Aparna Goel

Michael Fallon

Bartley Thornburg

Lisa VanWagner

Jennifer C Lai

K Pallav Kolli

Affiliations

Soon will be listed here.

Abstract

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/L.

Results: A total of 601 patients were included. The median absolute change in platelets was 1 × 10/L (-26 × 10/L to 25 × 10/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/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/L before TIPS. The median absolute platelet change was 14 × 10/L (2 × 10/L to 34 × 10/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/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/L.

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