Local Platelet Trapping as the Cause of Thrombocytopenia after Hepatic Cryotherapy

Cryosurgery has been shown to be an effective approach to destruction of unresectable hepatic tumors. However, hepatic cryoablation may also be associated with local and systemic side effects, including thrombocytopenia and clotting dysfunction. Although thrombocytopenia is known to relate to the ma...

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Bibliographic Details
Published in:World journal of surgery 2005-05, Vol.29 (5), p.657-660
Main Authors: Pistorius, Georg A., Alexander, Christof, Krisch, Carl‐Martin, Feifel, Gernot, Schilling, Martin K., Menger, Michael D.
Format: Article
Language:English
Subjects:
Aged
Cryotherapy - adverse effects
Decrease Platelet Count
Female
Hepatocellular Injury
Humans
Liver - diagnostic imaging
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - surgery
Magnetic Resonance Imaging
Male
Middle Aged
Platelet Activation
Platelet Count
Platelet Destruction
Postoperative Observation Period
Prospective Studies
Radionuclide Imaging
Remote Organ Injury
Thrombocytopenia - etiology
Thrombocytopenia - physiopathology
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Summary:Cryosurgery has been shown to be an effective approach to destruction of unresectable hepatic tumors. However, hepatic cryoablation may also be associated with local and systemic side effects, including thrombocytopenia and clotting dysfunction. Although thrombocytopenia is known to relate to the magnitude of hepatocellular injury, its etiology is still unknown. With the use of whole‐body scintigraphy after injection of indium‐111‐labeled platelets we here demonstrated in six patients undergoing cryoablation of hepatic tumors that manifestation of systemic thrombocytopenia after cryosurgery is associated with excessive platelet trapping and destruction within the cryolesion. We therefore conclude that local platelet trapping represents a major cause of cryothermia‐induced systemic thrombocytopenia.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-005-7543-4