Article
Platelet sequestration correlates with cold ischemia time and hepatocellular injury after liver transplantation
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Published: | April 26, 2013 |
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Introduction: Experimental studies provide evidence that i) platelets accumulate in the postischemic liver and play a critical role for ischemia-reperfusion (I/R) injury, ii) interventions against platelet recruitment reduce hepatocellular damage and improve postoperative survival in various models of liver ischemia and transplantation. In this study, we answered the question whether platelet loss after liver transplantation depends on cold ischemia time and correlates with hepatocellular injury in liver transplant patients.
Material and methods: We analyzed retrospective data of patients undergoing cadaveric donor liver transplantation in 2011 in our transplantation center. Patients were divided in three groups according to cold ischemia time: A) 5-8h (n=7), B) 9-10h (n=19), C) 11-13h (n=9). We compared platelet counts and liver enzyme activities before transplantation and during the first three postoperative days. The analysis of platelet counts considered perioperative substitution of platelet concentrates.
Results: After liver transplantation, the total number of circulating platelets was reduced in group A at 40±13% on the 1st day, at 39±14% on the 2nd day and at 51±17% on the 3rd day as compared to the preoperative values. Platelet loss was higher in group B (51±7%, 74±6%, 78±8%, respectively) and reached the highest values in group C (58±7%, 84±19%, 83±15%, respectively). The liver enzyme activities correlated with the extent of platelet sequestration (Table 1 [Tab. 1]).
Conclusion: Our clinical data show that platelet sequestration after liver transplantation correlates with the duration of cold ischemia and hepatocellular injury. These results support the experimental data and discuss platelets as a potential target for future interventions against I/R injury during liver transplantation.