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Date of last update: 10/15/2017.

Forum Name: Liver Diseases

Question: Cirrhosis with low platelets count

 syedmujahid - Sun Dec 02, 2007 12:11 pm

Dear Doctor,

My brother is 58 years old and suffering from liver Cirrhosis for last 5 years, had 3 times band legation to stop oseophgus bleeding. For the last few months he is also having ascites and doctor has given him dieutrics to reduce the fluid.
Current ultrasound examination shows His spleen has enlarged, HB and platelets count has dropped. Earlier the Count was 52000 and now is 48000. He repeatedly get bleeding from gums.
Can you please advise us if he can get the platelets transfusion in order to increase the platelets counts and better clotting.
Our Doctor says that this will temporarily help and again after a week or so the count will drop. His blood group is O-ve
To stop bleeding he some times get injection of Vit K and Transmin.

I will be waiting for your kind opinion in this regard.

Thank and best Regards.

Mujahid from Pakistan

 Dr. Chan Lowe - Wed Jan 30, 2008 10:27 pm

User avatar Hello Mujahid,

Receiving a platelet transfusion will increase his platelet count and can help stop bleeding that is occurring at the time. However, I suspect that the reason your brother's platelets are low is due to splenic sequestration. Basically, when the spleen becomes enlarged (probably due to the cirrhosis) it can begin to trap the platelets and destroy them.

With this sequestration occurring, if a transfusion is given the transfused platelets also will be destroyed and ultimately the platelet count will drop again. The vitamin K and transmin injections will not help platelets. They may help, however, because when the liver begins to fail it stops processing the vitamin K needed to make other clotting factors. Increasing the levels of vitamin K can help increase amounts of the clotting factors to help prevent bleeding due to these deficiencies.

The ultimate repair may be a liver transplant. In some cases, a splenectomy may help because it will eliminate the sequestration issue. However, this has its own side effects and consequences and may not be an appropriate treatment for all.

If he is actively bleeding a platelet transfusion will stop the bleeding, though, since the platelets will stop the bleeding before they get chewed up.

Follow up with his doctor is important.

Best wishes.

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