title: Prognostic impact of postoperative low platelet count after liver transplantation.
abstract: The positive impact of platelets has been recently implicated in liver transplantation (LT). The aim of this study was to determine the risk factors for graft loss and mortality after LT, focusing on perioperative platelet counts.
  
  
  
  We reviewed all deceased donor LT from 2000 to 2012 and enrolled 975 consecutive recipients. The risk factors for graft loss and mortality were analyzed by multivariate analysis, using Cox's regression model.
  
  
  
  Using cutoff values acquired by receiver operating characteristics curve analysis, multivariate analyses determined that viral hepatitis C (hazard ratio [HR]=1.32), donor age >40 (HR=1.33), higher peak serum alanine aminotransferase (HR=1.01), reoperation within 30 days (HR=1.51), and platelet count <72 500/μL on postoperative day (POD) 5 (HR=1.30) were independent risk factors for graft loss. Viral hepatitis C (HR=1.33), reoperation within 30 days (HR=1.35), and platelet count <72 500/μL on POD 5 (HR=1.38) were independent risk factors for mortality.
  
  
  
  A low platelet count on POD 5 was associated with graft loss and mortality after LT. Platelet count <72 500/μL on POD 5 can be a predictor of poor graft and overall survival. Maintaining higher postoperative platelet counts could potentially improve graft and overall survival rates.
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Shunji
authors.initials: S
authors.lastname: Nagai
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Krishna G
authors.initials: KG
authors.lastname: Putchakayala
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Safwan
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Li
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Kane
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Priyanka L
authors.initials: PL
authors.lastname: Singh
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Collins
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Rizzari
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Gabriel T
authors.initials: GT
authors.lastname: Schnickel
authors.affiliation: Department of Transplantation and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Marwan S
authors.initials: MS
authors.lastname: Abouljoud
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000209:etiology* / Q000473:pathology; D006085:Graft Survival; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology* / Q000473:pathology
keywords: graft survival; liver transplantation; overall survival; platelet; thrombocytopenia