Z Gastroenterol 2022; 60(01): e14
DOI: 10.1055/s-0041-1740692
Abstracts | GASL

Platelet function testing in patients with liver cirrhosis and TIPS implantation

Authors

  • Huber Patrick

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

  • Nassar Asala

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

  • Stallmann Daniela

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

  • Sharipova Diana

    2   Department of Cardiology and Angiology I, University Heart Center Freiburg and Faculty of Medicine, Freiburg, Germany

  • AliHamad Muataz

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

  • Reincke Marlene

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

  • Sturm Lukas

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

  • Schultheiß Michael

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

  • Duerschmied Daniel

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

  • Thimme Robert

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

  • Krauel Krystin

    2   Department of Cardiology and Angiology I, University Heart Center Freiburg and Faculty of Medicine, Freiburg, Germany

  • Bettinger Dominik

    1   Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
Weitere Informationen
Auch verfügbar auf
 

Background Transjugular intrahepatic portosystemic shunt (TIPS) implantation is an effective treatment of portal hypertension in patients with liver cirrhosis. The use of covered stents has reduced TIPS thrombosis. However, the role of anticoagulation or platelet inhibition after TIPS implantation is not clear and different approaches are used. In order to establish strategies for platelet inhibition after TIPS, the functionality of platelets in patients with portal hypertension has to be clarified. The aim of our study was to assess platelet function before and after TIPS implantation.

Methods Platelet aggregation was tested in patients before TIPS implantation, 4 and 30 days following the procedure using light transmission aggregometry (LTA) and whole blood impedance aggregometry (WBIA). Surface platelet activation markers and platelet-neutrophil complexes (PNCs) as inflammatory marker were assessed using flow cytometry. Thrombin receptor activating peptide 6 (TRAP-6), adenosine diphosphate (ADP) and arachidonic acid (AA) were used as agonists.

Results Platelet aggregation values were reduced in WBIA, they were mostly within the normal range in LTA. P-selectin expression and GPIIb/IIIa activation were low at baseline and increased after stimulation with a diminished GPIIb/IIIa activation in response to TRAP-6. PNCs were already present at baseline with lower percentages 30 days following TIPS.

Conclusions PNCs were present in patients with TIPS implantation while platelet pre-activation was not observed. The lower percentages of PNCs 30 days after TIPS may be due to a reduced inflammatory state. This and the discrepancy of platelet function testing in WBIA compared to LTA needs to be further investigated.



Publikationsverlauf

Artikel online veröffentlicht:
26. Januar 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany