Comparison of Platelet Count Reduction in Patients awaiting Liver Transplantation with and without Primary Sclerosing Cholangitis: A Cohort Study

Arch Iran Med. 2020 Nov 1;23(11):732-739. doi: 10.34172/aim.2020.97.

Abstract

Background: Thrombocytopenia is the most well-known hematological abnormality occurring in patients with liver cirrhosis. However, the rate of platelet count reduction is not the same across different chronic liver disease etiologies. Therefore, the aim of the present study was to compare the differences in the platelet count levels between primary sclerosing cholangitis-related cirrhosis (PSC-C) and other causes of liver disease.

Methods: In this cohort study, the association between PSC-C and risk of platelet count reduction was investigated. The platelet counts were repeatedly measured among 242 consecutive cirrhotic patients (144 males and 98 females) including 67 patients with PSC-C and 175 patients with non-PSC-C who were on the waiting list for liver transplantation. The Poisson regression analysis was used to assess the relationship between platelet count reduction and PSC-C, after adjusting for potential confounding factors.

Results: During the five years of follow-up, comparison between the two groups revealed that significantly higher levels of platelet were found in PSC-C patients when compared to the non-PSC-C group [148 (106-280) (×103 /µL) vs. 79 (50-110) (×103 /µL), respectively, P < 0.001]. After adjusting for confounding factors, a significant association was observed between non-PSC-C and the risk of platelet count reduction (relative risk, RR: 14.81, 95% CI: 1.21-160.42; P = 0.03).

Conclusion: The findings indicate that PSC-C patients present with mild degrees of thrombocytopenia compared to other causes of chronic liver disease.

Keywords: Liver cirrhosis; Liver transplantation; Primary sclerosing cholangitis; Thrombocytopenia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cholangitis, Sclerosing / complications*
  • Cholangitis, Sclerosing / physiopathology
  • Cholangitis, Sclerosing / surgery
  • Cohort Studies
  • Female
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / physiopathology
  • Liver Cirrhosis / surgery
  • Liver Transplantation
  • Male
  • Middle Aged
  • Platelet Count*
  • Regression Analysis
  • Risk Factors
  • Thrombocytopenia / blood
  • Thrombocytopenia / etiology*
  • Waiting Lists*
  • Young Adult