Impact of graft size on postoperative thrombocytopenia in living donor liver transplant.
OBJECTIVE
Perioperative variables, including portal venous pressure (PVP) and graft size, can predict thrombocytopenia after living donor liver transplant (LDLT).


METHODS
Retrospective analysis.


METHODS
University hospital.


METHODS
Forty-five adult patients with liver cirrhosis who underwent LDLT without splenectomy (n = 38) or with simultaneous splenectomy (n = 7).


METHODS
Preoperative and postoperative platelet counts and perioperative variables of recipient age, preoperative Model for End-Stage Liver Disease score, donor age, graft volume to standard liver volume ratio, PVP, cold and warm ischemia times, blood loss, and surgical complications.


RESULTS
In the 38 recipients who did not undergo splenectomy, there was a strong correlation between PVP at the completion of the transplant and the platelet count (at 14 and 28 days and at 3 months). A high PVP (> or = 25 mm Hg) correlated with posttransplant thrombocytopenia, as did a small graft. Patients undergoing a simultaneous splenectomy had sufficient platelet levels at each measurement, irrespective of the graft volume.


CONCLUSIONS
Portal venous pressure and graft size were associated with posttransplant thrombocytopenia. Splenectomy is an option in cases with a high PVP or a small graft, especially for patients receiving postoperative interferon therapy for hepatitis C virus.
Marubashi
Shigeru
S
Department of Surgery and Clinical Oncology, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
Dono
Keizo
K
Miyamoto
Atsushi
A
Takeda
Yutaka
Y
Nagano
Hiroaki
H
Umeshita
Koji
K
Monden
Morito
M
D000328:Adult; D001794:Blood Pressure; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy / Q000601:surgery; D006785:Hospitals, University; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011169:Portal Vein / Q000503:physiopathology*; D012189:Retrospective Studies; D013156:Splenectomy; D013921:Thrombocytopenia / Q000209:etiology / Q000503:physiopathology*; D019737:Transplants
D007372:Interferons