title: Low immediate postoperative platelet count is associated with hepatic insufficiency after hepatectomy.
abstract: OBJECTIVE
  To investigate the relationship between low immediate postoperative platelet count and perioperative outcome after liver resection in patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  In a cohort of 565 consecutive hepatitis B-related HCC patients who underwent major liver resection, the characteristics and clinical outcomes after liver resection were compared between patients with immediate postoperative platelet count < 100 × 10(9)/L and patients with platelet count ≥ 100 × 10(9)/L. Risk factors for postoperative hepatic insufficiency were evaluated by multivariate analysis.
  
  
  RESULTS
  Patients with a low immediate postoperative platelet count (< 100 × 10(9)/L) had more grade III-V complications (20.5% vs 12.4%, P = 0.016), and higher rates of postoperative liver failure (6.8% vs 2.6%, P = 0.02), hepatic insufficiency (31.5% vs 21.2%, P < 0.001) and mortality (6.8% vs 0.5%, P < 0.001), compared to patients with a platelet count ≥ 100 × 10(9)/L. The alanine aminotransferase levels on postoperative days 3 and 5, and bilirubin on postoperative days 1, 3 and 5 were higher in patients with immediate postoperative low platelet count. Multivariate analysis revealed that immediate postoperative low platelet count, rather than preoperative low platelet count, was a significant independent risk factor for hepatic insufficiency.
  
  
  CONCLUSIONS
  A low immediate postoperative platelet count is an independent risk factor for hepatic insufficiency. Platelets can mediate liver regeneration in the cirrhotic liver.
authors.affiliation: Hai-Qing Wang, Jian Yang, Jia-Yin Yang, Wen-Tao Wang, Lu-Nan Yan, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Hai-Qing
authors.initials: HQ
authors.lastname: Wang
authors.affiliation: Hai-Qing Wang, Jian Yang, Jia-Yin Yang, Wen-Tao Wang, Lu-Nan Yan, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yang
authors.affiliation: Hai-Qing Wang, Jian Yang, Jia-Yin Yang, Wen-Tao Wang, Lu-Nan Yan, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Jia-Yin
authors.initials: JY
authors.lastname: Yang
authors.affiliation: Hai-Qing Wang, Jian Yang, Jia-Yin Yang, Wen-Tao Wang, Lu-Nan Yan, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Wen-Tao
authors.initials: WT
authors.lastname: Wang
authors.affiliation: Hai-Qing Wang, Jian Yang, Jia-Yin Yang, Wen-Tao Wang, Lu-Nan Yan, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Lu-Nan
authors.initials: LN
authors.lastname: Yan
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000401:mortality; D048550:Hepatic Insufficiency / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D006801:Humans; D017093:Liver Failure / Q000097:blood / Q000209:etiology; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008115:Liver Regeneration; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010976:Platelet Count; D011237:Predictive Value of Tests; D012307:Risk Factors; D013921:Thrombocytopenia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D000410:Alanine Transaminase; D001663:Bilirubin
keywords: Hepatectomy; Hepatic insufficiency; Hepatitis B; Hepatocellular carcinoma; Thrombocytopenia