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

摘要

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 68x10(9)/L and High Platelet Group (128 patients) with platelet >68x10(9)/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 (1275mL vs. 800mL, 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 68x10(9)/L is an independent risk factor for EAD.Platelet maybe influences the functional status of the liver by promoting graft regeneration after liver transplantation.