Immediate postoperative low platelet count is associated with delayed liver function recovery after partial liver resection.
OBJECTIVE
To evaluate whether a low postoperative platelet count is associated with a poor recovery of liver function in patients after partial liver resection.


BACKGROUND
Experimental studies in rodents have recently suggested that blood platelets play a critical role in the initiation of liver regeneration. It remains unclear whether platelets are also involved in liver regeneration in humans.


METHODS
In a series of 216 consecutive patients who underwent partial liver resection for colorectal liver metastases, we studied postoperative mortality and liver dysfunction in relation to the immediate postoperative platelet count. All patients had normal preoperative liver function and none of them had liver fibrosis or cirrhosis. Delayed postoperative recovery of liver function was defined as serum bilirubin >50 micromol/L or prothrombin time >20 seconds at any time point between postoperative day 1 and 5.


RESULTS
Patients with a low (<100 x10(9)/L) immediate postoperative platelet count had worse postoperative liver function, higher serum markers of liver injury, and increased mortality compared with patients with normal platelet counts (>100/L). A low immediate postoperative platelet count was identified as an independent risk factor of delayed postoperative recovery of liver function (OR, 11.5; 95% CI, 1.1-122.4; P = 0.04 in multivariate analysis).


CONCLUSIONS
After partial liver resection, a low platelet count is an independent predictor of delayed postoperative liver function recovery and is associated with increased risk of postoperative mortality. These clinical findings are in accordance with the accumulating evidence from experimental studies, indicating that platelets play a critical role in liver regeneration.
Alkozai
Edris M
EM
Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Nijsten
Maarten W
MW
de Jong
Koert P
KP
de Boer
Marieke T
MT
Peeters
Paul M J G
PM
Slooff
Maarten J
MJ
Porte
Robert J
RJ
Lisman
Ton
T
D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008099:Liver / Q000502:physiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors