Transient thrombopoietin peak after liver transplantation for end‐stage liver disease

Abstract

Summary. Knowledge about synthesis of thrombopoietin (TPO) by human liver cells is now well established and makes the study of TPO serum levels and interdependency with platelet concentrations important before and after liver transplantation. We followed these variables in 14 patients suffering from primary biliary cirrhosis (group A), 10 with hepatitis B (group B) and nine with hepatitis C (group C) infections, as well as 11 patients suffering from alcoholic cirrhosis (group D). In the pretransplant serum samples, TPO levels and platelet counts revealed median values (range) of 112´75 pg/ml (5´0±349´3) in group A, 67´8 pg/ml (14´8±249´9) in B, 68´6 pg/ml (31´4±147´3) in C and 57´9 pg/ml (25´2±264´2) in D for TPO, and 138 Â 10 9 /l (36±243) in A, 48 Â 10 9 /l (22±129) in B, 105 Â 10 9 /l (32±176) in C and 109 Â 10 9 /l (33±285) in D for platelets, the latter levels being abnormally reduced. Within 2±3 d of transplantation, the TPO levels started to increase to transient peaks of mostly 5±10 times baseline, which were followed by continuous correction of thrombocytopenia. Splenomegaly was identified to be an important co-factor of thrombocytopenia in groups A and D. We conclude that decreased TPO production in patients with end-stage liver diseases is reverted by orthotopic liver transplantation.

Acute thrombocytopenia after liver transplant: Role of platelet activation, thrombopoietin deficiency and response to high dose intravenous IgG treatment

“…TPO increase could sustain platelet turnover following liver transplant [10,11,18,19] as demonstrated here by RP absolute number and percentage which showed a parallel pattern of changes with an early peak in the peri-operative time and a second peak at POD6-POD8, followed by a progressive RP decrease. The post-OLT peak in TPO levels preceded by two days the appearance of RPs and by four days the normalization of platelet count [20,21].…”

Thrombopoietin in Acute Liver Failure

“…TPO production in cirrhosis seems to be regulated by the portal blood supply to the liver, 25 and TPO levels increase shortly after liver transplantation followed by a correction of pretransplant thrombocytopenia. 26,27 In conclusion, despite severe hepatic dysfunction serum TPO levels increase in patients with ALF but not sufficiently to prevent the development of thrombocytopenia. This increase is probably caused by increased TPO production, and the location of this increased production remains to be studied.…”

Toxicological evaluation of methanol leaves extract of <i>Vernonia bipontini</i> Vatke in blood, liver and kidney tissues of mice

“…The fall in hemoglobin content and RBC count can be correlated with induction of anemia in mice treated with methanol leaf extract of the plant at 800mg/kg 29 . The reduced number of platelets (thrombocytopenia) and RBC in the circulating blood might be due to the observed enlarged spleen which could probably trap and store them excessively 31,32 and the platelets deficiency might also induce hemorrhage 31 .…”