@article {4144,
	title = {Immune thrombocytopenic purpura following liver transplantation: a case series and review of the literature.},
	journal = {Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society//Liver Transpl},
	volume = {12},
	year = {2006},
	month = {2006},
	pages = {781 - 91},
	publisher = {Taylor,Ryan M. Division of Gastroenterology, University of Michigan, Ann Arbor, MI 48109-0362, USA.},
	address = {United States},
	abstract = {Thrombocytopenia is common among liver transplant candidates and recipients. The aim of our study was to determine the incidence and outcome of new-onset immune-mediated thrombocytopenic purpura (ITP) following liver transplantation at a single center. Among the 256 liver transplant recipients with an International Classification of Diseases, Ninth Edition code for thrombocytopenia, 8 cases of new-onset ITP were identified, leading to an overall incidence of 0.7\% in 1,105 consecutive liver transplant recipients over a 15-year period. All 8 patients were Caucasian, 5 (63\%) were male, and the median age at ITP onset was 54 years (range, 15-63). The median platelet count at presentation was 3,500 cells/mL (range, 1,000-12,000) and liver disease was due to hepatitis C (38\%), primary sclerosing cholangitis (38\%), and cryptogenic cirrhosis (25\%). The median time from transplant to ITP onset was 53.5 months (range, 1.9-173). Three of the 6 patients tested (50\%) had cell-bound antiplatelet antibodies, 1 patient had an underlying hematological malignancy, and none of the organ donors had a history of ITP. Corticosteroids and/or immunoglobulin infusions were effective in 4 patients. However, serial rituximab infusions were required in 4 patients with persistent thrombocytopenia, and 3 of them eventually required splenectomy to induce disease remission. At a median follow-up of 19.7 months, 7 long-term survivors remain in remission with a median platelet count of 267,000 cells/mL. In conclusion, new-onset ITP is an infrequent but important cause of severe thrombocytopenia in liver transplant recipients. Corticosteroids and immunoglobulin infusions were effective in 50\% while the remainder of patients required rituximab infusions or eventual splenectomy for long-term disease remission.},
	keywords = {*Liver Transplantation/ae [Adverse Effects], *Purpura, Thrombocytopenic, Idiopathic/et [Etiology], Adolescent, Female, Humans, Male, Middle Aged},
	isbn = {1527-6465},
	author = {Taylor, Ryan M and Bockenstedt, Paula and Su, Grace L and Marrero, Jorge A and Pellitier, Shawn M and Fontana, Robert J}
}
