Review article: Blood platelet number and function in chronic liver disease and cirrhosis.

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http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2036.2008.03674.x

Alimentary Pharmacology & Therapeutics

To cite this article: P. WITTERS, K. FRESON, C. VERSLYPE, K. PEERLINCK, M. HOYLAERTS, F. NEVENS, C. VAN GEET, D. CASSIMAN (2008) Review article: Blood platelet number and function in chronic liver disease and cirrhosis. doi:10.1111/j.1365-2036.2008.03674.x (Online Accepted)

Review article: Blood platelet number and function in chronic liver disease and cirrhosis.

P. WITTERS1,21 Laboratory of Hepatology, University of Leuven, B-3000 Leuven, Belgium2 Department of Pediatrics, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium, K. FRESON33 Center for Molecular and Vascular Biology, University of Leuven, B-3000 Leuven, Belgium, C. VERSLYPE1,41 Laboratory of Hepatology, University of Leuven, B-3000 Leuven, Belgium4 Department of Hepatology, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium, K. PEERLINCK3,53 Center for Molecular and Vascular Biology, University of Leuven, B-3000 Leuven, Belgium5 Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium, M. HOYLAERTS33 Center for Molecular and Vascular Biology, University of Leuven, B-3000 Leuven, Belgium, F. NEVENS1,41 Laboratory of Hepatology, University of Leuven, B-3000 Leuven, Belgium4 Department of Hepatology, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium, C. VAN GEET2,32 Department of Pediatrics, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium3 Center for Molecular and Vascular Biology, University of Leuven, B-3000 Leuven, Belgium, D. CASSIMAN1,41 Laboratory of Hepatology, University of Leuven, B-3000 Leuven, Belgium4 Department of Hepatology, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium

1 Laboratory of Hepatology, University of Leuven, B-3000 Leuven, Belgium2 Department of Pediatrics, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium3 Center for Molecular and Vascular Biology, University of Leuven, B-3000 Leuven, Belgium4 Department of Hepatology, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium5 Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, B-3000 Leuven, Belgium

Responsible Author/ reprint request: WittersAfd. Hepatologie, O. & N. 1,Herestraat 49 -bus 703,BE-3000 Leuven,BelgiumTel + 32 (0)16 34 58 45Fax + 32 (0)16 34 58 46.witters@...

Abstract

Background: The liver plays a central role in coagulation and fibrinolysis but is also closely intertwined with the function and number of blood platelets.

Aim and Methods: To describe and integrate all literature concerning ‘liver disease’ and ‘blood platelets’ by performing a thorough literature research.

Results: Thrombocytopenia is a marked feature of chronic liver disease and cirrhosis. Traditionally, this thrombocytopenia was attributed to passive platelet sequestration in the spleen. More recent insights suggest an increased platelet breakdown and to a lesser extent decreased platelet production play a more important role.

Besides the reduction in number, other studies also suggest functional platelet defects. This platelet dysfunction is probably both intrinsic to the platelets and secondary to soluble plasma factors. It reflects not only a decrease in aggregability, but also an activation of the intrinsic inhibitory pathways. The net effect, finally, is a decreased platelet function in the various types of chronic liver diseases and cirrhosis.

Finally, recent data suggest platelets are not only affected by but can also contribute to the liver disease process as for instance in viral hepatitis and cholestatic liver disease.

Conclusions: Platelet research in liver disease is a growing area of investigation and could provide new pathophysiological insights.