Therapeutic factors considered according to the preoperative splenic volume for a prolonged increase in platelet count after partial splenic embolization for liver cirrhosis

Infarcted splenic volume has been identified as the predictive factor for a prolonged increase in platelet count after partial splenic embolization (PSE). However, despite enough infarcted splenic volume, some patients show only a slight increase in platelet counts after PSE because of rapid regrowth of the noninfarcted splenic parenchyma within several months post-PSE. The purpose of this study was to determine the therapeutic factors based on the preoperative splenic volume for a prolonged increase in platelet counts after PSE. In 72 cirrhotic patients with follow-ups longer than 1 year post-PSE, depending on the preoperative splenic volume, the splenic factors associated with a prolonged increase in platelet counts at 1 year after PSE were retrospectively examined. In 57 patients with preoperative splenic volumes a parts per thousand currency sign700 ml, the preoperative splenic volume (P = 0.001), infarcted splenic volume (P < 0.001), and splenic infarction ratio (P = 0.001) showed positive correlations with increments in platelet counts at 1 year post-PSE. In 15 patients with preoperative splenic volumes > 700 ml, noninfarcted splenic volume (P = 0.003) and splenic infarction ratio (P = 0.002) showed negative and positive correlations with the increment in platelet counts at 1 year post-PSE, respectively. In patients with splenic volumes a parts per thousand currency sign700 ml, the infarcted splenic area significantly affects the prolonged increase in platelet counts post-PSE. In patients with splenic volumes > 700 ml, the noninfarcted splenic area is significant.