Thrombopoietin levels in patients with cirrhosis before and after orthotopic liver transplantation

Background: Thrombocytopenia is a common manifestation of cirrhosis. Objectives: To determine plasma thrombopoietin levels in cirrhotic patients with thrombocytopenia, monitor those levels before and after orthotopic liver transplantation, and compare thrombopoietin messenger RNA (mRNA) levels in liver samples from cirrhotic patients and controls. Design: A cross-sectional study of patients with cirrhosis, including a small subset of patients who had orthotopic liver transplantation. Setting: University-affiliate hospital. Patients: 44 patients with cirrhosis, including 17 patients who had orthotopic liver transplantation. Intervention: Orthotopic liver transplantation. Measurements: Plasma thrombopoietin levels in all patients, platelet counts in all patients, and thrombopoietin mRNA levels in liver samples from nine patients with cirrhosis and eight controls. Results: Thrombopoietin levels were undetectable in 39 of 44 patients with cirrhosis. In 16 of 17 patients, the levels became detectable after liver transplantation. Thrombopoietin mRNA levels were decreased in liver samples from patients with cirrhosis compared with controls (P = 0.0103). Conclusions: The low thrombopoietin levels in cirrhotic patients with thrombocytopenia and the increased levels after orthotopic liver transplantation suggest that impaired production of thrombopoietin may contribute to thrombocytopenia associated with cirrhosis.