Division of Gastroenterology and Hepatology, MedStar Georgetown Transplant Institute, Georgetown University School of Medicine, 3800 Reservoir Road NW, 2-PHC, Washington, DC 20007, USA.
Division of Gastroenterology and Hepatology, Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, 676 North St Clair Street, Arkes Suite 1900, Chicago, IL 60611, USA.
Clin Liver Dis. 2020 Aug;24(3):437-451. doi: 10.1016/j.cld.2020.04.009. Epub 2020 May 31.
Thrombocytopenia is common in advanced liver disease, and such patients frequently need invasive procedures. Numerous mechanisms for thrombocytopenia exist, including splenic sequestration and reduction of levels of the platelet growth factor thrombopoietin. Traditionally, platelet transfusions have been used to increase platelet counts before elective procedures, usually to a threshold of greater than or equal to 50,000/μL, but levels vary by provider, procedure, and specific patient. Recently, the thrombopoietin receptor agonists avatrombopag and lusutrombopag were studied and found efficacious for increasing platelet count in the outpatient setting for select patients with advanced liver disease who need a procedure.
血小板减少症在晚期肝病中很常见，此类患者经常需要进行有创性操作。血小板减少症存在多种机制，包括脾脏隔离和血小板生成素血小板生长因子水平降低。传统上，血小板输注已用于在择期手术前增加血小板计数，通常阈值大于或等于 50,000/μL，但水平因提供者、操作和具体患者而异。最近，研究了血小板生成素受体激动剂avatrombopag 和 lusutrombopag，发现它们在门诊环境中对有需要的晚期肝病患者有效，可增加血小板计数需要进行操作。
