title: Association of thrombocytopenia with outcome following adult living donor liver transplantation.
abstract: This study aimed to evaluate the association of postoperative thrombocytopenia with outcome following adult living donor liver transplantation (LDLT) for end-stage liver disease (ESLD). It was a prospective study of 120 consecutive adult LDLT from September 2012 to May 2015. Preoperative platelet counts (PLTs) and postoperative PLTs were recorded at regular intervals till 3 months after LDLT. Univariate and multivariate analyses were performed. The median pretransplant PLT was 61 × 10(9) /l. The lowest median PLT after LDLT was observed on POD 3. Patients were stratified into low platelet group (n = 83) with PLT <30 × 10(9) /l and high platelet group (n = 37) with PLT ≥30 × 10(9) /l. Patients with PLT <30 × 10(9) /l had statistically significant higher grade III/IV complication (P = 0.001), early graft dysfunction (P = 0.01), sepsis (P = 0.001), and prolonged ascites drainage (P = 0.002). On multivariate analysis, PLT<30 × 10(9) /l was identified as an independent risk factor for grade III/IV complications (P = 0.005). Overall, patients survival was significantly different between two groups (P = 0.04), but this predictive value was lost in patients who survived more than 90 days (P = 0.37). Postoperative PLT of <30 × 10(9) /l was a strong predictor of major postoperative complications and is associated with early graft dysfunction, prolonged ascites drainage, and sepsis. The perioperative mortality rate was high in the thrombocytopenia group.
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver & Biliary Sciences, New Delhi, India. viniyendra@yahoo.co.uk.
authors.forename: Viniyendra
authors.initials: V
authors.lastname: Pamecha
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: Shyam Sunder
authors.initials: SS
authors.lastname: Mahansaria
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: Senthil
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: Kishore Gurumoorthy Subramanya
authors.initials: KG
authors.lastname: Bharathy
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: Shridhar Vasantrao
authors.initials: SV
authors.lastname: Sasturkar
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: Piyush Kumar
authors.initials: PK
authors.lastname: Sinha
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: Niteen
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Liver Transplantation and Hepato Pancreatico Biliary Surgery, Institute of Liver & Biliary Sciences, New Delhi, India.
authors.forename: Vaibhaw
authors.initials: V
authors.lastname: Kumar
mesh_terms: D000328:Adult; D001201:Ascites / Q000150:complications; D058625:End Stage Liver Disease / Q000150:complications / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010976:Platelet Count; D011183:Postoperative Complications; D011184:Postoperative Period; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000150:complications; D013921:Thrombocytopenia / Q000209:etiology*; D016896:Treatment Outcome
keywords: end-stage liver disease; living donor liver transplantation; platelet counts