title: Thrombocytosis in liver transplant recipients: prevalence, natural history, and impact.
abstract: The prevalence, natural history, and implications of reactive thrombocytosis after liver transplantation (LT) are unknown. Prospectively collected data from July 2000 to February 2006 were analyzed. Post-LT thrombocytosis was defined as a platelet count of > 450 x 10(3)/microL lasting for >7 days and starting within 8 weeks of transplantation. In patients who survived >8 weeks, graft and patient outcomes were compared with liver transplant recipients who survived >8 weeks and did not develop any thrombocytosis. Post-LT thrombocytosis was seen in 92 (14.7%) of 627 patients. The median onset was on day 13 (range, days 1-44) and the peak platelet count was seen on day 17 (range, days 3-110). The median duration of thrombocytosis was 25 days (range, 7-1,253 days), with a median peak platelet count of 625 x 10/microL (range, 472-1,381 x 10/microL). Seronegative fulminant hepatic failure was the indication for transplantation in 18% of patients with post-LT thrombocytosis compared with 3% of controls (P < 0.001). There was a lower proportion of patients transplanted for hepatitis C-related cirrhosis in the thrombocytosis group (10% vs. 18%, P = 0.04). The occurrence of hepatic arterial thrombosis was similar in the 2 groups (5% vs. 4%, P = NS). None of the 4 patients with platelet count higher than 1,000 x 10/microL developed thrombotic complications. Post-LT thrombocytosis is more often associated with seronegative fulminant hepatic failure, and there is a negative association with hepatitis C-related cirrhosis. Post-LT thrombocytosis does not increase the risk of hepatic artery thrombosis, and patients without thrombotic complications should not be treated.
authors.affiliation: Liver and Hepatobiliary Unit, Queen Elizabeth Hospital, Birmingham, UK. akseth2003@yahoo.com
authors.forename: Avnish K
authors.initials: AK
authors.lastname: Seth
authors.forename: Bridget K
authors.initials: BK
authors.lastname: Gunson
authors.forename: Darius F
authors.initials: DF
authors.lastname: Mirza
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Haydon
mesh_terms: D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D010976:Platelet Count; D015995:Prevalence; D013922:Thrombocytosis / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology*; D016896:Treatment Outcome