Preoperative predictors of platelet transfusion in adult patients undergoing liver transplant

Liver transplantat (LT) is still associated with a significant need for blood product transfusion. This study aimed to identify preoperative factors that can predict the need for platelet transfusion in adults undergoing LT.

A retrospective analysis of the database from liver transplant recipients was performed to evaluate the use of platelet transfusion during and after LT. Two groups of recipients were assigned, with or without perioperative platelet transfusion (groups A and B, respectively). Preoperative LT recipient variables such as age, gender, body mass index, pre-transplant laboratory tests, cause of liver transplant, the Model for End-Stage Liver Disease score, and other selected perioperative variables, including surgical data, were compared between the two groups.

Of 150 patients, 70 who received platelet transfusions were included in group A. Regarding the preoperative recipient variables, the two groups showed significant differences in the Model for End-Stage Liver Disease score (p=0.013), pre-transplant platelet count (p<0.001), and international normalized ratio (p<0.001). The results of logistic regression analysis showed that pre-transplant platelet count <50×10⁹/L (odds ratio, 0.979; 95% confidence interval [0.969-0.989]; p<0.001), serum creatinine ≥123.76 µmol/L (1.4 mg/dL) (OR, 4.35; 95% CI [1.566-12.097]; p=0.005), international normalized ratio ≥1.5 (OR, 2.771; 95% CI [1.198-6.412]; p=0.017) were identified as predictors for the use of platelet transfusion in LT.

Pre-liver transplant recipients' platelet count, serum creatinine, and international standardized ratio are crucial in predicting platelet utilization during and after LT.