Factors predicting persistent thrombocytopenia after living donor liver transplantation in pediatric patients

Area of Science:

• Pediatric Hepatology
• Transplantation Immunology
• Hematology

Background:

• Thrombocytopenia is a frequent complication following liver transplantation (LT) in pediatric patients with end-stage liver disease.
• Understanding the incidence and predictors of post-transplant thrombocytopenia (PLT) is crucial for optimizing patient outcomes.

Purpose of the Study:

• To evaluate the incidence of thrombocytopenia in pediatric patients after living donor liver transplantation (LDLT).
• To identify predictive factors associated with post-transplant thrombocytopenia (PLT <100,000/mm³).

Main Methods:

• Retrospective analysis of 76 pediatric patients (≤15 years) who underwent LDLT.
• Evaluation of platelet counts at two weeks and 12 months post-transplant.
• Univariate and multivariate analyses to determine associations with thrombocytopenia.

Main Results:

• Prevalence of thrombocytopenia was 28.9% at two weeks and 17.7% at 12 months post-LDLT.
• Early thrombocytopenia was associated with age at transplant, preoperative platelet count, graft-to-recipient weight ratio (GRWR), acute rejection, and CMV infection.
• Preoperative platelet count, GRWR, and acute rejection were significant predictors in multivariate analysis; preoperative platelet count was the sole predictor at 12 months.

Conclusions:

• Preoperative platelet count, GRWR, and acute rejection are significant factors influencing thrombocytopenia after pediatric LDLT.
• Post-operative monitoring of platelets aids in early detection of adverse events related to the liver graft.
• Successful treatment of vascular complications led to platelet count recovery.