There are several treatment options available for ITP when steroids aren't appropriate. The main alternatives include:

- Intravenous immunoglobulin (IVIG) - This treatment uses concentrated antibodies from donors and can help raise platelet counts within days
- Thrombopoietin receptor agonists (like Promacta or Nplate) - These medications help your bone marrow produce more platelets
- Rituximab (Rituxan) - This medication blocks immune cells from making antibodies that destroy platelets Given your complex medical situation, it would be beneficial to seek a second opinion from another hematologist-oncologist who specializes in ITP treatment. Each treatment option has different benefits and risks that need to be carefully evaluated based on your specific health conditions. A specialist can work with you to develop a personalized treatment plan that takes into account your liver condition.