Association of thrombocytopenia with outcome following adult living donor liver transplantation

• Published in: Transplant international Vol. 29; no. 10; pp. 1126 - 1135
• Main Authors: Pamecha, Viniyendra, Mahansaria, Shyam Sunder, Kumar, Senthil, Bharathy, Kishore Gurumoorthy Subramanya, Sasturkar, Shridhar Vasantrao, Sinha, Piyush Kumar, Kumar, Niteen, Kumar, Vaibhaw
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.10.2016
• Subjects: Adult; Ascites - complications; End Stage Liver Disease - complications; End Stage Liver Disease - surgery; end‐stage liver disease; Female; Graft Survival; Humans; Liver; Liver Transplantation - adverse effects; living donor liver transplantation; Living Donors; Male; Middle Aged; Mortality; Multivariate Analysis; Platelet Count; platelet counts; Postoperative Complications; Postoperative Period; Risk Factors; ROC Curve; Sensitivity and Specificity; Sepsis - complications; Thrombocytopenia - etiology; Treatment Outcome; end-stage liver disease; living donor liver transplantation; platelet counts
• ISSN: 0934-0874; 1432-2277
• DOI: 10.1111/tri.12819

Summary This study aimed to evaluate the association of postoperative thrombocytopenia with outcome following adult living donor liver transplantation (LDLT) for end‐stage liver disease (ESLD). It was a prospective study of 120 consecutive adult LDLT from September 2012 to May 2015. Preoperative platelet counts (PLTs) and postoperative PLTs were recorded at regular intervals till 3 months after LDLT. Univariate and multivariate analyses were performed. The median pretransplant PLT was 61 × 109/l. The lowest median PLT after LDLT was observed on POD 3. Patients were stratified into low platelet group (n = 83) with PLT <30 × 109/l and high platelet group (n = 37) with PLT ≥30 × 109/l. Patients with PLT <30 × 109/l had statistically significant higher grade III/IV complication (P = 0.001), early graft dysfunction (P = 0.01), sepsis (P = 0.001), and prolonged ascites drainage (P = 0.002). On multivariate analysis, PLT<30 × 109/l was identified as an independent risk factor for grade III/IV complications (P = 0.005). Overall, patients survival was significantly different between two groups (P = 0.04), but this predictive value was lost in patients who survived more than 90 days (P = 0.37). Postoperative PLT of <30 × 109/l was a strong predictor of major postoperative complications and is associated with early graft dysfunction, prolonged ascites drainage, and sepsis. The perioperative mortality rate was high in the thrombocytopenia group.