Immediate Postoperative Low Platelet Counts After Living Donor Liver Transplantation Predict Early Allograft Dysfunction

Medicine (Baltimore). 2015 Aug;94(34):e1373. doi: 10.1097/MD.0000000000001373.

Abstract

To investigate whether the platelets can improve liver function by mediating liver regeneration. Using a retrospective cohort with 234 consecutive adult-to-adult living donor liver transplantation recipients, we have discussed the relationship between immediate postoperative platelet count and outcome. Patients have been stratified into Low Platelet Group (106 patients) with platelet ≤68 × 10/L and High Platelet Group (128 patients) with platelet >68 × 10/L.Low Platelet Group has a higher rate of preoperative thrombocytopenia (90.6% vs. 32.8%, P<0.001), higher model for end-stage liver disease score (15 vs. 11, P<0.001), cirrhosis (86.8% vs. 76.6%, P=0.046), hepatorenal syndrome (18.2% vs. 4.0%, P=0.005) and fulminant hepatic failure (26.4% vs. 7.8%, P<0.001). The packed red blood cells transfusion (7.5 vs. 5, P = 0.023) and plasma transfusion (1275 mL vs. 800 mL, P=0.001) are more in patients with low platelet count. Low Platelet Group has a higher early allograft dysfunction (EAD) (22.6% vs. 7.0%, P=0.001) and severe complications (22.6% vs. 10.9%, P = 0.016). The 90-day mortality between the 2 groups is similar. The multivariate analysis has found that postoperative platelet ≤68 × 10/L is an independent risk factor for EAD.Platelet maybe influences the functional status of the liver by promoting graft regeneration after liver transplantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • China
  • End Stage Liver Disease / surgery*
  • Female
  • Graft Survival*
  • Humans
  • Liver Transplantation* / adverse effects
  • Liver Transplantation* / methods
  • Liver Transplantation* / mortality
  • Living Donors*
  • Male
  • Middle Aged
  • Platelet Count / methods*
  • Postoperative Complications* / blood
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / mortality
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Thrombocytopenia* / blood
  • Thrombocytopenia* / diagnosis
  • Thrombocytopenia* / etiology
  • Thrombocytopenia* / mortality
  • Time Factors
  • Treatment Outcome