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Peripheral platelet count correlates with liver atrophy and predicts long-term mortality on the liver transplant

Wissam Bleibel1, Stephen H Caldwell, Michael P Curry

  • 1Liver Center, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA.

Transplant International : Official Journal of the European Society for Organ Transplantation
|January 30, 2013
PubMed

Insights

Liver atrophy is linked to low platelet counts in cirrhosis patients, impacting survival. Reduced platelet counts indicate advanced liver atrophy and higher mortality risk for those awaiting liver transplants.

Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Hematology

Background:

  • Liver atrophy is implicated in cirrhosis-related thrombocytopenia due to decreased thrombopoietin production.
  • Understanding the relationship between liver size and platelet count is crucial for managing patients with end-stage liver disease.

Purpose of the Study:

  • To investigate the correlation between liver volume ratio (LVR) and platelet count in patients awaiting liver transplantation.
  • To assess the predictive value of platelet count and LVR on mortality and transplantation rates.

Main Methods:

  • Volumetric liver measurements using computed tomography and laboratory tests were performed on 181 patients listed for liver transplantation.
  • Liver volume ratio (LVR) was calculated as actual liver volume divided by expected normal liver volume (Heinemann formula).
  • Statistical analyses were used to determine correlations between LVR, Model for End-Stage Liver Disease (MELD) score, serum albumin, and platelet count, and to evaluate their impact on mortality.

Main Results:

  • Platelet count showed a stronger correlation with LVR (P < 0.0001) than with MELD score or serum albumin (P = 0.003).
  • A lower platelet count (< 100,000/mcL) was a significant independent predictor of mortality (HR 0.987, P = 0.001).
  • Patients with platelet counts below 100,000/mcL had significantly shorter survival (935 vs. 1396 days, P = 0.002) and higher death rates (42.2% vs. 23.6%, P = 0.01).

Conclusions:

  • Low platelet count in cirrhosis patients is strongly associated with advanced liver atrophy.
  • Platelet count is a critical indicator of increased waiting list mortality in liver transplant candidates.
  • Monitoring platelet counts is essential for risk stratification and management of patients with end-stage liver disease awaiting transplantation.

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