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Long-term dynamics of hematological data and spleen volume in cirrhotic patients after liver transplantation-various dynamics depending on etiology.

Ishigami M, Ishizu Y, Onishi Y, Kamei H, Kiuchi T, Itoh A, Hirooka Y, Katano Y, Goto H - Springerplus (2013)

Bottom Line: However, detailed dynamics, especially over a long term, are not fully understood.We studied 53 cirrhotic patients who underwent liver transplantation at our institute and followed for more than 1 year.Unique dynamics and correlations between them were found among the different etiologies investigated.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Nagoya University School of Medicine, 65 Tsuruma-cho, Showa-ku, 466-8550 Nagoya, Japan.

ABSTRACT

Background: Hypersplenism is a common complication in cirrhotic patients, and liver transplantation would be one of the effective treatments. However, detailed dynamics, especially over a long term, are not fully understood. We investigated the long-term dynamics of hematological data and spleen volumes, as well as their correlation in cirrhotic patients who underwent liver transplantation.

Patients and methods: We studied 53 cirrhotic patients who underwent liver transplantation at our institute and followed for more than 1 year. Hematological data were collected from medical records, while spleen volumes were determined by CT volumetry at 0, 1, 3, 6, 12, 24, 36, 48, 60 postoperative months (POM).

Results: (1) Platelet (Plt) and hemoglobin (Hb) levels were gradually increased up to 18 and 10 POM, respectively, in contrast with white blood cells (WBC), which remained mostly unchanged from pretransplantation levels. (2) Spleen volume was sharply decreased in the first POM, then showed a slower but steady decline up to 48 POM. (3) Spleen volume was significantly correlated with hematological data, though the levels were generally weak (Plt: r = 0.433, p < 0.001; Hb: r = 0.233, p < 0.001; WBC: r = 0.217, p = 0.001). (4) Spleen volume was strongly correlated with all hematological parameters in HBV patients (Plt: r = 0.617, p < 0.0001; Hb: r = 0.401, p < 0.001; WBC: r = 0.387, p < 0.001), in contrast with that in other etiologies, which had generally weak correlations though some were statistically significant.

Conclusions: We investigated the long-term dynamics of hematological data and spleen volume in cirrhotic patients after liver transplantation. Unique dynamics and correlations between them were found among the different etiologies investigated.

No MeSH data available.


Related in: MedlinePlus

a. Dynamics of spleen volumes after liver transplantation. **p < 0.01 in comparison between spleen volumes at baseline and 1 POM. *p < 0.05 in comparison between spleen volumes at 1 POM and 12 POM, and 12 POM and 48 POM. b. Dynamics of spleen volumes among different etiologies after liver transplantation. Black closed line: HBV, black broken line: HCV, gray closed line: PBC, gray broken line: NBNC, *(black asterisk) p < 0.05 in comparison between spleen volumes at baseline and 3 POM, and 3 POM and 36 POM in HBV, and those at baseline and 12 POM, and 12 POM and 48 POM in HCV. *(gray asterisk) p < 0.05 in comparison between spleen volumes at baseline and 1 POM, and 1 POM and 24 POM in PBC.
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Fig4: a. Dynamics of spleen volumes after liver transplantation. **p < 0.01 in comparison between spleen volumes at baseline and 1 POM. *p < 0.05 in comparison between spleen volumes at 1 POM and 12 POM, and 12 POM and 48 POM. b. Dynamics of spleen volumes among different etiologies after liver transplantation. Black closed line: HBV, black broken line: HCV, gray closed line: PBC, gray broken line: NBNC, *(black asterisk) p < 0.05 in comparison between spleen volumes at baseline and 3 POM, and 3 POM and 36 POM in HBV, and those at baseline and 12 POM, and 12 POM and 48 POM in HCV. *(gray asterisk) p < 0.05 in comparison between spleen volumes at baseline and 1 POM, and 1 POM and 24 POM in PBC.

Mentions: Spleen volumes showed a slow, but steady and significant decrease at least until 48 POM (Figure 4a). The differences regarding dynamics among the different etiologies are shown in Figure 4b. In viral patients, spleen volumes showed a steady decrease over the long term, while in patients with PBC, a sharp decline was seen at 1 POM then a slower decrease occurred up to 24 POM. In contrast, there were no significant changes within 60 months after liver transplantation in the NBNC patients.Figure 4


Long-term dynamics of hematological data and spleen volume in cirrhotic patients after liver transplantation-various dynamics depending on etiology.

Ishigami M, Ishizu Y, Onishi Y, Kamei H, Kiuchi T, Itoh A, Hirooka Y, Katano Y, Goto H - Springerplus (2013)

a. Dynamics of spleen volumes after liver transplantation. **p < 0.01 in comparison between spleen volumes at baseline and 1 POM. *p < 0.05 in comparison between spleen volumes at 1 POM and 12 POM, and 12 POM and 48 POM. b. Dynamics of spleen volumes among different etiologies after liver transplantation. Black closed line: HBV, black broken line: HCV, gray closed line: PBC, gray broken line: NBNC, *(black asterisk) p < 0.05 in comparison between spleen volumes at baseline and 3 POM, and 3 POM and 36 POM in HBV, and those at baseline and 12 POM, and 12 POM and 48 POM in HCV. *(gray asterisk) p < 0.05 in comparison between spleen volumes at baseline and 1 POM, and 1 POM and 24 POM in PBC.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3755816&req=5

Fig4: a. Dynamics of spleen volumes after liver transplantation. **p < 0.01 in comparison between spleen volumes at baseline and 1 POM. *p < 0.05 in comparison between spleen volumes at 1 POM and 12 POM, and 12 POM and 48 POM. b. Dynamics of spleen volumes among different etiologies after liver transplantation. Black closed line: HBV, black broken line: HCV, gray closed line: PBC, gray broken line: NBNC, *(black asterisk) p < 0.05 in comparison between spleen volumes at baseline and 3 POM, and 3 POM and 36 POM in HBV, and those at baseline and 12 POM, and 12 POM and 48 POM in HCV. *(gray asterisk) p < 0.05 in comparison between spleen volumes at baseline and 1 POM, and 1 POM and 24 POM in PBC.
Mentions: Spleen volumes showed a slow, but steady and significant decrease at least until 48 POM (Figure 4a). The differences regarding dynamics among the different etiologies are shown in Figure 4b. In viral patients, spleen volumes showed a steady decrease over the long term, while in patients with PBC, a sharp decline was seen at 1 POM then a slower decrease occurred up to 24 POM. In contrast, there were no significant changes within 60 months after liver transplantation in the NBNC patients.Figure 4

Bottom Line: However, detailed dynamics, especially over a long term, are not fully understood.We studied 53 cirrhotic patients who underwent liver transplantation at our institute and followed for more than 1 year.Unique dynamics and correlations between them were found among the different etiologies investigated.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Nagoya University School of Medicine, 65 Tsuruma-cho, Showa-ku, 466-8550 Nagoya, Japan.

ABSTRACT

Background: Hypersplenism is a common complication in cirrhotic patients, and liver transplantation would be one of the effective treatments. However, detailed dynamics, especially over a long term, are not fully understood. We investigated the long-term dynamics of hematological data and spleen volumes, as well as their correlation in cirrhotic patients who underwent liver transplantation.

Patients and methods: We studied 53 cirrhotic patients who underwent liver transplantation at our institute and followed for more than 1 year. Hematological data were collected from medical records, while spleen volumes were determined by CT volumetry at 0, 1, 3, 6, 12, 24, 36, 48, 60 postoperative months (POM).

Results: (1) Platelet (Plt) and hemoglobin (Hb) levels were gradually increased up to 18 and 10 POM, respectively, in contrast with white blood cells (WBC), which remained mostly unchanged from pretransplantation levels. (2) Spleen volume was sharply decreased in the first POM, then showed a slower but steady decline up to 48 POM. (3) Spleen volume was significantly correlated with hematological data, though the levels were generally weak (Plt: r = 0.433, p < 0.001; Hb: r = 0.233, p < 0.001; WBC: r = 0.217, p = 0.001). (4) Spleen volume was strongly correlated with all hematological parameters in HBV patients (Plt: r = 0.617, p < 0.0001; Hb: r = 0.401, p < 0.001; WBC: r = 0.387, p < 0.001), in contrast with that in other etiologies, which had generally weak correlations though some were statistically significant.

Conclusions: We investigated the long-term dynamics of hematological data and spleen volume in cirrhotic patients after liver transplantation. Unique dynamics and correlations between them were found among the different etiologies investigated.

No MeSH data available.


Related in: MedlinePlus