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Thrombocytopenia after liver transplantation
M A Chatzipetrou1, A K Tsaroucha, D Weppler
1Department of Surgery, University of Miami School of Medicine/Jackson Memorial Hospital, Florida 33136, USA.
Transplantation
|March 30, 1999
Summary
Post-transplant thrombocytopenia in liver transplant patients is linked to preoperative low platelets, transfusions, and re-transplantation. These factors, along with early rejection, predict poorer patient and graft survival.
Area of Science:
- Hepatology
- Transplantation Immunology
- Hematology
Background:
- Thrombocytopenia is a common early complication after orthotopic liver transplantation (OLT).
- The causes and impact of post-OLT thrombocytopenia on transplant outcomes require further clarification.
Purpose of the Study:
- To identify factors contributing to thrombocytopenia following OLT.
- To investigate the correlation between thrombocytopenia, early rejection, and patient survival.
Main Methods:
- Analysis of 541 OLTs performed between June 1994 and September 1997.
- Examined preoperative platelet count, intra-operative transfusions, rejection, CMV status, and re-transplantation.
- Assessed correlation with nadir platelet count and overall survival.
Main Results:
- A significant drop in platelet count occurred in most patients within the first two weeks post-OLT.
- Preoperative platelet count, intra-operative transfusions, re-transplantation, and early rejection were associated with thrombocytopenia.
- Nadir platelet count and percentage of platelet fall predicted patient and graft survival.
Conclusions:
- Immediate post-transplant thrombocytopenia is associated with preoperative low platelet count, transfusions, and re-transplantation, indicating a poorer preoperative state.
- Thrombocytopenia correlates with allograft dysfunction, rejection, and reduced patient and graft survival.
- A rise in platelet count after two weeks suggests proper graft function.