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首页> 中文期刊> 《世界胃肠病学杂志：英文版》 >Severe thrombocytopenia before liver transplantation is associated with delayed recovery of thrombocytopenia regardless of donor type

Severe thrombocytopenia before liver transplantation is associated with delayed recovery of thrombocytopenia regardless of donor type

         
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AIM: To compare the recovery of thrombocytopenia and splenomegaly during long-term follow-up after liver transplantation in patients receiving a living donor transplant or a cadaveric donor transplant. METHODS: This was a retrospective cohort study of 216 consecutive liver transplant patients who survived for > 6 mo after transplantation; 169 received a liver transplant from a living donor and 47 from a cadaveric donor. The platelet counts or spleen volumes were examined before transplant, 1, 6, and 12 mo after transplant, and then annually until 5 years after transplant. RESULTS: The mean follow-up period was 49 mo (range, 21-66). Platelet counts increased continu-ously for 5 years after orthotopic liver transplant. The restoration of platelet counts after transplant was sig-nificantly slower in patients with severe pretransplant thrombocytopenia (< 50 000/μL) until 4 years after transplant (P = 0.005). Donor type did not significantly affect the recovery of platelet count and spleen vol-ume in either patient group. In multivariate analysis, pretransplant severe thrombocytopenia (< 50 000/μL) was an independent factor associated with sustained thrombocytopenia (P < 0.001, odds ratio 6.314; con-fidence interval, 2.828-14.095). Thrombocytopenia re-appeared after transplant in seven patients with portal flow disturbance near the anastomosis site. CONCLUSION: Our study suggests that severe throm-bocytopenia before transplant is closely associated with delayed recovery of platelet count after transplant and donor type did not affect the recovery of throm-bocytopenia. The reappearance of thrombocytopenia after transplant should be considered a possible indica-tor of flow disturbance in the portal vein.

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