Sudhindran S, Sunil S, Sinha S
Peter Medawar Transplant Unit, Royal Liverpool University Hospital, Liverpool, UK.
Transplant Proc. 2006 Jun;38(5):1549-51. doi: 10.1016/j.transproceed.2006.03.035.
Increased platelet counts has been reported to be a sequela of pancreas transplantation and even incriminated in the increased rate of thrombosis of pancreas grafts. The aim of the study was to measure the platelet counts after simultaneous kidney-pancreas transplantations compared to kidney transplants alone in diabetic patients.
This retrospective case-control study included 57 patients who received simultaneous pancreas and kidney transplants (SPK), from 1985 to 2000 and had functioning grafts for more than 1 month. The control patients were 38 type I diabetic recipients of kidney transplants alone (KTA), matched for sex, era, and immunosuppression. The platelet counts, white cell counts, and hemoglobin were analyzed on the preoperative day, weeks 1 to 6, 3 months, 6 months and 1 year.
The mean age of the SPK group was significantly lower than that of the KTA group (39.8+/-8.3 versus 48.2+/-11.7, P<.01). Significantly higher platelet counts were demonstrated during weeks 2 to 6, which persisted at 3 months and at 1 year among the SPK compared to the KTA group. Although significantly higher white cell counts and lower hemoglobin levels were seen among the SPK versus KTA group during weeks 3 to 6, it did not persist after 3 months.
The mean platelet counts of patients with simultaneous pancreas and kidney transplantation was significantly higher than that of diabetic patients with kidney transplants alone. This thrombocytosis persisted up to the first year and cannot be explained by an increased amount of blood loss or higher infectious complications in the SPK group. Routine antiplatelet prophylaxis is recommended in this group of patients.
据报道，血小板计数增加是胰腺移植的后遗症，甚至被认为与胰腺移植血栓形成率增加有关。本研究的目的是比较糖尿病患者同期肾胰腺移植与单纯肾移植后的血小板计数。
这项回顾性病例对照研究纳入了1985年至2000年间接受同期胰腺和肾移植（SPK）且移植肾功能良好超过1个月的57例患者。对照患者为38例仅接受肾移植（KTA）的I型糖尿病受者，在性别、年代和免疫抑制方面进行了匹配。在术前、第1至6周、3个月、6个月和1年时分析血小板计数、白细胞计数和血红蛋白。
SPK组的平均年龄显著低于KTA组（39.8±8.3对48.2±11.7，P<0.01）。与KTA组相比，SPK组在第2至6周期间血小板计数显著更高，在3个月和1年时仍持续升高。虽然在第3至6周期间SPK组的白细胞计数显著更高且血红蛋白水平更低，但3个月后并未持续。
同期胰腺和肾移植患者的平均血小板计数显著高于单纯肾移植的糖尿病患者。这种血小板增多症持续至第一年，且不能用SPK组失血量增加或感染并发症增多来解释。建议对该组患者进行常规抗血小板预防。
