Digestive Diseases and Sciences

, Volume 43, Issue 11, pp 2459–2462 | Cite as

Does Transjugular Intrahepatic Portosystemic Shunt (TIPS) Resolve Thrombocytopenia Associated with Cirrhosis?

  • Nicolas Jabbour
  • Albert Zajko
  • Philip Orons
  • William Irish
  • John J. Fung
  • Robert Rick Selby


Thrombocytopenia is frequently present inpatients with cirrhosis. The effect of portaldecompression on thrombocytopenia using a variety ofshunt procedures has been contradictory. Transjugularintrahepatic portosystemic shunt (TIPS) has been proposed asa less invasive procedure for portal decompression,mainly for control of variceal bleeding or intractableascites. Its effect on thrombocytopenia has not been defined yet. The aim of this review is todefine the effect of TIPS on patients with cirrhosis andthrombocytopenia. Sixty-two patients who underwent TIPSat the University of Pittsburgh and survived without transplant for more than two monthswere included. Platelet count was determined prior toTIPS as well as at one-week, one-month, and three-monthintervals after TIPS. The prevalence of thrombocytopenia prior to TIPS was 49%. TIPS had no effect onthrombocytopenia even when the portosystemic gradientwas reduced to less than 12 mm Hg. In conclusion, portaldecompression after TIPS did not affect the degree of thrombocytopenia.



Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sullivan BJ Jr, Tumen H: The e ffect of portacaval shunt on thrombocytopenia associated with portal hype rtension. Ann Intern Med 55(4):598-602, 1961PubMedGoogle Scholar
  2. 2.
    Moschcowitz E: The pathogene sis of splenome galy in hype rtension of the portal circulation: “conge stive splenomegaly.” Medicine 27:187, 1948Google Scholar
  3. 3.
    Mutchnick M, Lerner E, Conn H: Effect of portacaval anastomosis on hypersplenism. Dig Dis Sci 25(12):929-938, 1980PubMedGoogle Scholar
  4. 4.
    Felix WR, Myerson R, Sigel B, Perrin E, Jackson F: The effect of portacaval shunt on hyperslenism. Surg Gynecol Obstet 139:899-903, 1989Google Scholar
  5. 5.
    Morris PW, Patton TB, Balint JA, Hirschowitz BL: Portal hype rtension, conge stive splenomegaly, and portacaval shunt. Gastroente rology 42:555-559, 1962Google Scholar
  6. 6.
    Hutson DG, Zeppa R, Levi JU, et al: The effect of the distal splenorenal shunt on hype rsplenism. Ann Surg 185:605-612, 1977PubMedGoogle Scholar
  7. 7.
    Sullivan BH, Jr., Tumen HJ: The effect of portacaval shunt on thrombocytopenia associated with portal hype rtension. Ann Intern Med 55:598-603, 1961PubMedGoogle Scholar
  8. 8.
    Puttini M, Marni A, Montes F, Belli L: Effect of portasystemic shunt on hype rsplenism. Clinical study in 129 patients with cirrhosis. Am Surg 45:444-448, 1979PubMedGoogle Scholar
  9. 9.
    Soper NJ, Rikkers LF: Effect of operations for variceal hemorrhage on hypersplenism. Am J Surg 144:700-703, 1982CrossRefPubMedGoogle Scholar
  10. 10.
    Vang J, Sime rt G, Hansson JA, et al: Results of a modified distal spleno-renal shunt for portal hype rtension. Ann Surg 185:224-228, 1977PubMedGoogle Scholar
  11. 11.
    Fe rrara J, Ellison C, Martin EW, Cooperman M: Correction of hype rsplenism following distal splenorenal shunt. Surgery 86:570-573, 1979PubMedGoogle Scholar
  12. 12.
    Yanaga K, Tzakis A, Shimade M, Campbell W, et al: Reversal of hypersplenism following orthotopic liver transplantation. Ann Surg 210(2):180-182, 1989PubMedGoogle Scholar
  13. 13.
    Conn HO: Transjugular intrahepatic portal-systemic shunts: The stage of the art. Hepatology 17:148-158, 1993CrossRefPubMedGoogle Scholar
  14. 14.
    Rossle M, Haag K, Ochs A, et al: The transjugular intrahepatic portosystemic stent-shunt procedure for variceal bleeding. N Engl J Med 330:165-171, 1994CrossRefPubMedGoogle Scholar
  15. 15.
    Jabbour N, Zajko A, Orons P, Irish W, et al: Transjugular intrahepatic portosystemic shunt in patients with end-stage liver disease: Expe rience in candidate and noncandidate patient for liver transplantation. Liver Transplant Surg 2(2):139- 147, 1996Google Scholar
  16. 16.
    Moore RM, Singleton AO: Spontaneous remission in Banti's syndrome and remission following splenectomy. InCurrent Surgical Manageme nt. Philadelphia, WB Saunders, 1957Google Scholar
  17. 17.
    Aseni P, Be ati CA, Vertemati A, Meroni A, Be lli L: Live r arterialization prevents thrombocytopenia after portacaval shunt in rats. Eur Surg Res 19:159-163, 1987PubMedGoogle Scholar
  18. 18.
    Hutchinson DE, Genton E, Porter KA, e t al: Plate let changes following clinical and expe rimental hepatic homotransplantation. Arch Surg 97:27-33, 1968PubMedGoogle Scholar
  19. 19.
    Thomas HC, McSween RN, White RG: Role of the liver in controlling the immunogenicity of comme nsal bacte ria in the gut. Lance t 1:1288-1291, 1973CrossRefGoogle Scholar
  20. 20.
    Triger DR, Wright R: Hype rglobulinemia in liver disease. Lance t 1:1494-1496, 1973CrossRefGoogle Scholar
  21. 21.
    Paramo JA, Rocha E: Hemostasis in advanced liver disease. Sem in Thromb Hemost 19( 3):184-190, 1993Google Scholar

Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • Nicolas Jabbour
  • Albert Zajko
  • Philip Orons
  • William Irish
  • John J. Fung
  • Robert Rick Selby

There are no affiliations available

Personalised recommendations