Prognostic impact of postoperative low platelet count after liver transplantation

• Published in: Clinical transplantation Vol. 31; no. 3; pp. np - n/a
• Main Authors: Takahashi, Kazuhiro, Nagai, Shunji, Putchakayala, Krishna G., Safwan, Mohamed, Li, Amy Y., Kane, William J., Singh, Priyanka L., Collins, Kelly M., Rizzari, Michael D., Yoshida, Atsushi, Schnickel, Gabriel T., Abouljoud, Marwan S.
• Format: Journal Article
• Language: English
• Published: Denmark 01-03-2017
• Subjects: Adult; Female; Follow-Up Studies; Graft Rejection - blood; Graft Rejection - etiology; Graft Rejection - pathology; Graft Survival; Hepatitis C virus; Humans; liver transplantation; Liver Transplantation - adverse effects; Male; Middle Aged; overall survival; platelet; Platelet Count; Postoperative Complications; Prognosis; Risk Factors; Survival Rate; thrombocytopenia; Thrombocytopenia - blood; Thrombocytopenia - etiology; Thrombocytopenia - pathology; graft survival; overall survival; platelet; thrombocytopenia; liver transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.12891

Background
The positive impact of platelets has been recently implicated in liver transplantation (LT). The aim of this study was to determine the risk factors for graft loss and mortality after LT, focusing on perioperative platelet counts.
Methods
We reviewed all deceased donor LT from 2000 to 2012 and enrolled 975 consecutive recipients. The risk factors for graft loss and mortality were analyzed by multivariate analysis, using Cox's regression model.
Results
Using cutoff values acquired by receiver operating characteristics curve analysis, multivariate analyses determined that viral hepatitis C (hazard ratio [HR]=1.32), donor age >40 (HR=1.33), higher peak serum alanine aminotransferase (HR=1.01), reoperation within 30 days (HR=1.51), and platelet count <72 500/μL on postoperative day (POD) 5 (HR=1.30) were independent risk factors for graft loss. Viral hepatitis C (HR=1.33), reoperation within 30 days (HR=1.35), and platelet count <72 500/μL on POD 5 (HR=1.38) were independent risk factors for mortality.
Conclusion
A low platelet count on POD 5 was associated with graft loss and mortality after LT. Platelet count <72 500/μL on POD 5 can be a predictor of poor graft and overall survival. Maintaining higher postoperative platelet counts could potentially improve graft and overall survival rates.