Two cases of liver cirrhosis treated with lusutrombopag before partial splenic embolization

Abstract

Lusutrombopag, a small molecule thrombopoietin receptor agonist, has been approved for the treatment of chronic liver disease-associated thrombocytopenia due to hypersplenism in patients scheduled to undergo elective invasive procedures in Japan. We performed partial splenic embolization (PSE) after administration of lusutrombopag in two patients with thrombocytopenia due to cirrhosis.　Case 1 involved a 50-year-old man who developed cirrhosis due to hepatitis B virus (HBV) infection and alcohol consumption. Case 2 involved a 30-year-old woman who developed cirrhosis due to HBV infection only. Lusutrombopag administration led to an increase in platelet count in both patients, and PSE was performed safely. However, in Case 2, the patient developed disseminated intravascular coagulation. Further study with a larger population is required to investigate the indications for and risks of the use of lusutrombopag.