Effect of transjugular intrahepatic portosystemic shunt on thrombocytopenia associated with cirrhosis

Thrombocytopenia is a frequent complication of cirrhosis. Its pathogenesis is not well known, but it has been suggested that splenic congestion induce d by portal hypertension may be a major contributory factor. However, the a vailable data regarding the effect of portal decompression either by surgic al shunts or transjugular intrahepatic portosystemic shunt (TIPS) on periph eral platelet count in cirrhotics is conflicting. We studied the effects of TIPS on platelet count and mean platelet volume, following a successful TI PS placement. The platelet count had a tendency to decrease but was not sta tistically significant (120,100 +/- 72,100/mm(3) before TIPS vs 99,800 +/- 51,400/mm(3) after TIPS). The mean platelet volume remained essentially unc hanged (9.8 +/- 1.5 fL before TIPS and 9.9 +/- 1.5 fL after TIPS). These re sults confirm that TIPS has an unpredictable effect on platelet count in ci rrhotic patients with thrombocytopenia. The lack of a consistent increase i n the peripheral mean platelet volume following TIPS placement suggests tha t TIPS is unable to significantly enhance the release of platelets sequeste red in the splenic compartment in portal hypertension.