Immune thrombocytopenic purpura following liver transplantation: A case series and review of the literature
dc.contributor.author | Taylor, Ryan M. | en_US |
dc.contributor.author | Bockenstedt, Paula | en_US |
dc.contributor.author | Su, Grace L. | en_US |
dc.contributor.author | Marrero, Jorge A. | en_US |
dc.contributor.author | Pellitier, Shawn M. | en_US |
dc.contributor.author | Fontana, Robert John | en_US |
dc.date.accessioned | 2007-05-02T14:19:02Z | |
dc.date.available | 2007-05-02T14:19:02Z | |
dc.date.issued | 2006-05 | en_US |
dc.identifier.citation | Taylor, Ryan M.; Bockenstedt, Paula; Su, Grace L.; Marrero, Jorge A.; Pellitier, Shawn M.; Fontana, Robert J. (2006). "Immune thrombocytopenic purpura following liver transplantation: A case series and review of the literature." Liver Transplantation 12(5): 781-791. <http://hdl.handle.net/2027.42/50676> | en_US |
dc.identifier.issn | 1527-6465 | en_US |
dc.identifier.issn | 1527-6473 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/50676 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=16628698&dopt=citation | en_US |
dc.description.abstract | Thrombocytopenia is common among liver transplant candidates and recipients. The aim of our study was to determine the incidence and outcome of new-onset immune-mediated thrombocytopenic purpura (ITP) following liver transplantation at a single center. Among the 256 liver transplant recipients with an International Classification of Diseases, Ninth Edition code for thrombocytopenia, 8 cases of new-onset ITP were identified, leading to an overall incidence of 0.7% in 1,105 consecutive liver transplant recipients over a 15-year period. All 8 patients were Caucasian, 5 (63%) were male, and the median age at ITP onset was 54 years (range, 15-63). The median platelet count at presentation was 3,500 cells/mL (range, 1,000-12,000) and liver disease was due to hepatitis C (38%), primary sclerosing cholangitis (38%), and cryptogenic cirrhosis (25%). The median time from transplant to ITP onset was 53.5 months (range, 1.9-173). Three of the 6 patients tested (50%) had cell-bound antiplatelet antibodies, 1 patient had an underlying hematological malignancy, and none of the organ donors had a history of ITP. Corticosteroids and/or immunoglobulin infusions were effective in 4 patients. However, serial rituximab infusions were required in 4 patients with persistent thrombocytopenia, and 3 of them eventually required splenectomy to induce disease remission. At a median follow-up of 19.7 months, 7 long-term survivors remain in remission with a median platelet count of 267,000 cells/mL. In conclusion, new-onset ITP is an infrequent but important cause of severe thrombocytopenia in liver transplant recipients. Corticosteroids and immunoglobulin infusions were effective in 50% while the remainder of patients required rituximab infusions or eventual splenectomy for long-term disease remission. Liver Transpl 12:781–791, 2006. © 2006 AASLD. | en_US |
dc.format.extent | 177825 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Life and Medical Sciences | en_US |
dc.subject.other | Surgery | en_US |
dc.title | Immune thrombocytopenic purpura following liver transplantation: A case series and review of the literature | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Hematology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Transplant Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, University of Michigan, Ann Arbor, MI ; Telephone: 734-936-4780; FAX: 734-936-7392 ; University of Michigan Medical Center, 3912 Taubman Center, Ann Arbor, MI 48109-0362 | en_US |
dc.identifier.pmid | 16628698 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/50676/1/20715_ftp.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1002/lt.20715 | en_US |
dc.identifier.source | Liver Transplantation | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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