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Impedance Aggregometry Reveals Increased Platelet Aggregation during Liver Transplantation
Mohamed Soliman1, Matthias Hartmann1
1Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Universität Duisburg-Essen, 45122 Essen, Germany.
Journal of Clinical Medicine
|November 14, 2019
Summary
Liver transplant patients show significantly increased platelet aggregation during surgery, which returns to normal by the end. This finding may guide platelet transfusion and antiplatelet therapy decisions.
Area of Science:
- Transplantation Medicine
- Hematology
- Surgical Pathology
Background:
- Liver transplantation is associated with altered platelet function, including thrombocytopenia and increased aggregation.
- Bedside assays for assessing platelet aggregation in these patients have not been extensively studied.
Purpose of the Study:
- To compare platelet aggregation in liver transplantation patients versus control surgical patients using impedance aggregometry.
- To investigate potential alterations in platelet activity during the liver transplantation procedure.
Main Methods:
- Impedance aggregometry was used to measure platelet aggregation with various activators (ristocetin, ADP, arachidonic acid, collagen, TRAP) at four time points during liver transplantation.
- Platelet counts were determined, and a ratio of aggregation to platelet count was calculated to account for thrombocytopenia.
- Statistical analysis included t-tests or Mann-Whitney U-tests.
Main Results:
- Liver transplant patients exhibited a 3.1-fold increase in ristocetin-induced platelet aggregation ratio compared to controls (p=0.001).
- Significant increases (approx. twofold) in ADP-, arachidonic acid-, collagen-, and TRAP-induced platelet aggregation ratios were also observed.
- Platelet aggregation normalized by the end of the liver transplantation procedure.
Conclusions:
- Impedance aggregometry revealed markedly increased platelet aggregation in some liver transplant patients.
- This assay may be valuable for guiding platelet transfusion strategies and optimizing antiplatelet therapy in liver transplant recipients.
