What is the livers role in platelet homeostasis and how is it affected by chronic liver disease?
The liver plays a critical role in the production of platelets. The hormone thrombopoietin regulates platelet production and is produced in the liver. There is a correlation between platelet number and severity of fibrosis. In fact, thrombopoietin production normalizes after liver transplantation in patients with advanced liver disease. In patients with cirrhosis, thrombocytopenia arises from the presence of cirrhosis (decrease thrombopoietin production), portal hypertension/hypersplenism (platelet sequestration and destruction), and from medical treatment. Medical treatment can include interferon for hepatitis C and chemotherapy for hepatocellular carcinoma. In patients with thrombocytopenia from cirrhosis, treatment for thrombocytopenia is seldom required unless the patient undergoes an invasive procedure and the platelet count is below than 50–60,000 per cubic millimeter. In patients undergoing interferon therapy for hepatitis C or chemotherapy for hepatocellular carcinoma, dose mod
