Surgery Preperation for Individuals With ITP

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Keith McCrae, MD, notes that anesthesiologists and surgeons prefer to have platelet counts around 100,000 in preparation for surgery. There are at least 3 strategies to prepare a patient with idiopathic thrombocytopenic purpura (ITP) for surgery, explains Howard A. Liebman, MD. These include infusing platelets inter-operatively, administering intravenous immunoglobulin (IVIG), or using a thrombopoietin agonist, such as romiplostim, preceding surgical intervention. In emergency surgeries, the treatment of choice, says Leibman, remains IVIG with platelets and possibly corticosteroids.