Association of thrombocytopenia with outcome following adult living donor liver transplantation.

Abstract

This study aimed to evaluate the association of postoperative thrombocytopenia with outcome following adult living donor liver transplantation (LDLT) for end-stage liver disease (ESLD). It was a prospective study of 120 consecutive adult LDLT from September 2012 to May 2015. Preoperative platelet counts (PLTs) and postoperative PLTs were recorded at regular intervals till 3months after LDLT. Univariate and multivariate analyses were performed. The median pretransplant PLT was 61×10(9) /l. The lowest median PLT after LDLT was observed on POD 3. Patients were stratified into low platelet group (n=83) with PLT <30×10(9) /l and high platelet group (n=37) with PLT ≥30×10(9) /l. Patients with PLT <30×10(9) /l had statistically significant higher grade III/IV complication (P=0.001), early graft dysfunction (P=0.01), sepsis (P=0.001), and prolonged ascites drainage (P=0.002). On multivariate analysis, PLT<30×10(9) /l was identified as an independent risk factor for grade III/IV complications (P=0.005). Overall, patients survival was significantly different between two groups (P=0.04), but this predictive value was lost in patients who survived more than 90days (P=0.37). Postoperative PLT of <30×10(9) /l was a strong predictor of major postoperative complications and is associated with early graft dysfunction, prolonged ascites drainage, and sepsis. The perioperative mortality rate was high in the thrombocytopenia group.