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Defining risk factors for post liver transplant thrombocytopenia

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Thrombocytopenia represents one of the most common complications of both hepatic cirrhosis and liver transplantation. Mechanism considered to be responsible for post liver transplant (LT) thrombocytopenia include: pooling of platelets in the enlarged spleen, immune-mediated mechanisms, hemodilution or sequestration of platelets in the reperfused liver graft and impaired production of thrombopoietin.In the present study we retrospectively analyzed 66 patients who underwent liver transplantation between May 2012 – February 2013 at Fundeni Clinical Institute Bucharest. Thrombocytopenia was defined as platelet count (PLT) under 150.000 platelets/?l, severe thrombocytopenia as platelet count under 25.000 platelets/?l. Our primary outcome was to determine perioperative risk factors for the development of severe thrombocytopenia. The results of our study suggest a strong correlation between spleen size and preoperative platelet count, regardless of the severity of the liver disease or the underlying pathology. The length of surgery, intraoperative blood loss and subsequent blood products transfusion are strong indicators for the need of platelet transfusion during liver transplantation. Platelet count continued to fall for the first two postoperative days and after that it showed un upward trent toward preopreative values but not reaching them during the seven days follow-up.

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