spleen removal after liver transplant

my husband was 2 1/2 yr post liver transplant, everything goes ok except of dropping down of his platelets counts.the dr give us option its either medication to rise platelet counts or spleen removal, we are afraid of spleen removal, if it will be successfullor not and what are the side effects after removal of spleen? and what is the better things to do if he dont undergo transplant, what are the effect of low platelet count?

[Thomas D Schiano, MD]

a lot depends on how low the platelet count is.  If they are very low, like below 20,000, treatment may be necessary.  before any definitive therapy is pursued, the reason why the platelets are low should be ascertained--ITP, recurrent hepatitis C, CMV, medications.  Any abdominal surgery after liver transplantation is fraught with increased morbidity.