Local platelet trapping as the cause of thrombocytopenia after hepatic cryotherapy.

Cryosurgery has been shown to be an effective approach to destruction of unresectable hepatic tumors. However, hepatic cryoablation may also be associated with local and systemic side effects, including thrombocytopenia and clotting dysfunction. Although thrombocytopenia is known to relate to the magnitude of hepatocellular injury, its etiology is still unknown. With the use of whole-body scintigraphy after injection of indium-111-labeled platelets we here demonstrated in six patients undergoing cryoablation of hepatic tumors that manifestation of systemic thrombocytopenia after cryosurgery is associated with excessive platelet trapping and destruction within the cryolesion. We therefore conclude that local platelet trapping represents a major cause of cryothermia-induced systemic thrombocytopenia.