Platelet counts are persistently increased following simultaneous pancreas and kidney transplantation.
BACKGROUND
Increased platelet counts has been reported to be a sequela of pancreas transplantation and even incriminated in the increased rate of thrombosis of pancreas grafts. The aim of the study was to measure the platelet counts after simultaneous kidney-pancreas transplantations compared to kidney transplants alone in diabetic patients.


METHODS
This retrospective case-control study included 57 patients who received simultaneous pancreas and kidney transplants (SPK), from 1985 to 2000 and had functioning grafts for more than 1 month. The control patients were 38 type I diabetic recipients of kidney transplants alone (KTA), matched for sex, era, and immunosuppression. The platelet counts, white cell counts, and hemoglobin were analyzed on the preoperative day, weeks 1 to 6, 3 months, 6 months and 1 year.


RESULTS
The mean age of the SPK group was significantly lower than that of the KTA group (39.8+/-8.3 versus 48.2+/-11.7, P<.01). Significantly higher platelet counts were demonstrated during weeks 2 to 6, which persisted at 3 months and at 1 year among the SPK compared to the KTA group. Although significantly higher white cell counts and lower hemoglobin levels were seen among the SPK versus KTA group during weeks 3 to 6, it did not persist after 3 months.


CONCLUSIONS
The mean platelet counts of patients with simultaneous pancreas and kidney transplantation was significantly higher than that of diabetic patients with kidney transplants alone. This thrombocytosis persisted up to the first year and cannot be explained by an increased amount of blood loss or higher infectious complications in the SPK group. Routine antiplatelet prophylaxis is recommended in this group of patients.
Sudhindran
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S
Peter Medawar Transplant Unit, Royal Liverpool University Hospital, Liverpool, UK.
Sunil
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S
Sinha
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S
D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery; D003928:Diabetic Nephropathies / Q000601:surgery; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D016035:Pancreas Transplantation / Q000502:physiology*; D010976:Platelet Count; D012016:Reference Values; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D006454:Hemoglobins