Thrombocytopenia following liver transplantation is associated with platelet consumption and thrombin generation.
Thrombocytopenia frequently occurs immediately after orthotopic liver transplantation. We have investigated the cause of this phenomenon in a cohort of 45 consecutive liver transplant recipients. The median preoperative platelet count (range) of 129 x 10(9)/l (14-719) fell to 56 x 10(9)/l (23-334) by the fourth postoperative day. The median preoperative reticulated platelet percentage (range) of 6.7% (2.2-23.9) increased to 16.4% (4.6-40.8) on day 7. There was a significant rise in prothrombin fragment F1.2 by the first postoperative day which was followed by rises in fibrinogen and fibrin degradation products. There was no increase in platelet-associated immunoglobulin or markers of endothelial activation. We conclude that there is an increased rate of platelet consumption associated with thrombin generation that reflects the magnitude of liver transplant surgery.
Richards
E M
EM
Department of Haematology, Addenbrooke's NHS Trust, Cambridge.
Alexander
G J
GJ
Calne
R Y
RY
Baglin
T P
TP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001779:Blood Coagulation Factors / Q000378:metabolism; D001792:Blood Platelets / Q000276:immunology; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D007075:Immunoglobulin M / Q000378:metabolism; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013917:Thrombin / Q000378:metabolism*; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology*
D001779:Blood Coagulation Factors; D007070:Immunoglobulin A; D007075:Immunoglobulin M; D013917:Thrombin