Elevated Soluble Platelet Glycoprotein VI Levels in Patients After Living Donor Liver Transplantation.
Plasma-soluble platelet glycoprotein VI (sGPVI) levels were examined in patients undergoing living donor liver transplantation (LDLT), and the relationship between platelet activation and thrombocytopenia was evaluated to understand the mechanism of thrombocytopenia in LDLT. Platelet counts were significantly higher in the donors compared to the recipient, and the plasma sGPVI levels increased in both groups after the operation. Regarding the relationship between the platelet counts and the sGPVI levels, the slope varied on different days, and it became negative on day 3, suggesting that the plasma sGPVI levels are related to platelet activation in LDLT. The frequency of complications was high in the nonsurvivors. The platelet counts were higher in the survivors than in the nonsurvivors on days 14 and 28. Although the plasma levels of sGPVI in the survivors increased after the operation, those in the nonsurvivors were high only on day 3. Although the ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 domain, member 13) levels were markedly reduced, von Willebrand factor (VWF) and VWF propeptide (VWFpp) were markedly elevated during LDLT. The antithrombin activity was significantly lower (day 14) and VWFpp (day 28) was significantly higher in the nonsurvivors than in the survivors. These findings suggest that platelet activation first occurs after LDLT, and it is high in the nonsurvivors on day 3. Thereafter, the hemostatic abnormality and vascular endothelial cell injuries may appear on days 14 and 28.
1 Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan.
Naoki
N
Takahashi
1 Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan.
Masanobu
M
Usui
2 Biology Laboratory, Discovery Research, Mochida Pharmaceutical Co, Ltd, Shizuoka, Japan.
Katsuki
K
Naitoh
3 Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Mie, Japan.
Hideo
H
Wada
1 Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan.
Toshiki
T
Mastsui
3 Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Mie, Japan.
Toshihiko
T
Kobayashi
4 Department of Blood Transfusion, Mie University Graduate School of Medicine, Mie, Japan.
Takeshi
T
Matsumoto
5 Hepatobiliary Pancreatic and Transplantation Surgery, Kyoto University Graduate School, Kyoto, Japan.
Shinji
S
Uemoto
1 Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan.
Shuji
S
Isaji
D000071120:ADAMTS13 Protein / Q000097:blood; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D015539:Platelet Activation; D010976:Platelet Count; D010980:Platelet Membrane Glycoproteins / Q000032:analysis*; D012995:Solubility; D017741:Survivors; D013997:Time Factors; D014841:von Willebrand Factor / Q000032:analysis
D010980:Platelet Membrane Glycoproteins; C098341:platelet membrane glycoprotein VI; D014841:von Willebrand Factor; D000071120:ADAMTS13 Protein
living donor liver transplantation; mortality; sGPVI; thrombocytopenia