ArticleBlood advances2020
A practical approach to evaluating postoperative thrombocytopenia.
Article in Blood advances, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Safety and efficacy of fondaparinux use in hemodialysis patients with heparin-induced thrombocytopenia: a systematic review.European journal of clinical pharmacology · 2025Pooled it
- Severe Postoperative Epistaxis Revealing Immune Thrombocytopenia: A Case Report.Journal of rhinology : official journal of the Korean Rhinologic Society · 2026Article
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- Thrombocytopenia and Anemia After Cardiac Surgery.American journal of hematology · 2025Article
- Systemic Impact of Platelet Activation in Abdominal Surgery: From Oxidative and Inflammatory Pathways to Postoperative Complications.International journal of molecular sciences · 2025Review
- Treatment of Heparin-Induced Thrombocytopenia (HIT) With Fondaparinux in a Patient With Liver Dysfunction.Cureus · 2025Article
- Development and validation of a nomogram prediction model for perioperative deep vein thrombosis risk in arthroplasty: a retrospective study.Frontiers in medicine · 2025Article
- Aortic Clamping Time Is Associated With Postoperative Thrombocytopenia Following Elective Open Abdominal Aortic Surgery.International journal of vascular medicine · 2025Article
- Postoperative Thrombocytopenia after Revision Arthroplasty: Features, Diagnostic and Therapeutic Considerations.Life (Basel, Switzerland) · 2024Article
- Analysis of influencing factors and construction of risk prediction model for postoperative thrombocytopenia in critically ill patients with heart disease.Journal of cardiothoracic surgery · 2024Article
- Local and Systemic Micro-Rheological Changes during Intestinal Anastomosis Operation: A Metabolic Dependence in an Experimental Model.Metabolites · 2024Article
- Intraoperative Oxygen Consumption and Postoperative Immune Response in Colorectal Oncological Surgery: A Prospective, Monocentric Pilot Study.Journal of personalized medicine · 2024Article
- Association between postoperative nadir platelet count and postoperative cardiovascular complications following septal myectomy in patients with hypertrophic cardiomyopathy: a retrospective cohort study.BMC cardiovascular disorders · 2024Article
- Periprocedural Thrombogenicity Change Is Associated With Subclinical Leaflet Thrombosis Progression in Patients Undergoing Transcatheter Aortic Valve Implantation.Circulation reports · 2023Article
- Effect of cardiopulmonary bypass on coagulation factors II, VII and X in a primate model: an exploratory pilot study.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- Novel Postoperative Serum Biomarkers in Atypical Meningiomas: A Multicenter Study.Neurosurgery · 2023Article
- A Comprehensive Review of Thrombocytopenia With a Spotlight on Intensive Care Patients.Cureus · 2022Review
- Postsurgical Thrombotic Microangiopathy and Deregulated Complement.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Identifying the cause(s) of postoperative thrombocytopenia is challenging. The postoperative period includes numerous interventions, including fluid administration and transfusion of blood products, medication use (including heparin), and increased risk of organ dysfunction and infection. Understanding normal thrombopoietin physiology and the associated expected postoperative platelet count changes is the crucial first step in evaluation. Timing of thrombocytopenia is the most important feature when differentiating causes of postoperative thrombocytopenia. Thrombocytopenia within 4 days of surgery is commonly caused by hemodilution and increased perioperative platelet consumption prior to thrombopoietin-induced platelet count recovery and transient platelet count overshoot. A much broader list of possible conditions that can cause late-onset thrombocytopenia (postoperative day 5 [POD5] or later) is generally divided into consumptive and destructive causes. The former includes common (eg, infection-associated disseminated intravascular coagulation) and rare (eg, postoperative thrombotic thrombocytopenic purpura) conditions, whereas the latter includes such entities as drug-induced immune thrombocytopenia or posttransfusion purpura. Heparin-induced thrombocytopenia is a unique entity associated with thrombosis that is typically related to intraoperative/perioperative heparin exposure, although it can develop following knee replacement surgery even in the absence of heparin exposure. Very late onset (POD10 or later) of thrombocytopenia can indicate bacterial or fungal infection. Lastly, thrombocytopenia after mechanical device implantation requires unique considerations. Understanding the timing and severity of postoperative thrombocytopenia provides a practical approach to a common and challenging consultation.
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