Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Public Hospital System of Paris, Pierre and Marie Curie University, Paris, France.
Liver Transpl. 2012 Mar;18(3):340-6. doi: 10.1002/lt.22456.
The platelet count (PC), the spleen size (SS), and the portal blood flow (PBF) have been independently studied in the perioperative period after orthotopic liver transplantation (OLT) for cirrhosis, but these parameters have not been described and analyzed in combination. We analyzed PC data and Doppler sonography measurements of SS and PBF from 125 adult patients before OLT and 1, 3, 6, 9, and 12 months after transplantation. A linear mixed model with fixed subject random intercepts was used. PCs increased significantly from 101.5 ± 68.5 × 10(9) /L before OLT to 162.4 ± 86 × 10(9) /L 1 month after OLT and remained stable for 1 year after the operation. PBF increased significantly from 619 ± 239 mL/minute before OLT to 1379 ± 491 mL/minute after OLT and remained stable during the first year. SS slowly decreased after OLT, but the decrease became significant only 9 months after the operation (13.8 ± 4.2 cm before OLT versus 11.7 ± 3.7 cm at 9 months, P < 0.05). The cirrhosis etiology did not influence the evolution of the parameters. With or without replication or interferon treatment before OLT, the hepatitis C group viruses did not influence PCs postoperatively. The evolution of SS was correlated to the evolution of PCs in the year after transplantation. In conclusion, PCs and PBF increase rapidly after OLT, whereas SS slowly decreases. The cirrhosis etiology does not influence the evolution of PCs. Thrombocytopenia and splenomegaly are 2 results of portal hypertension, but the rapid normalization of PBF does not completely or rapidly reverse these 2 phenomena.
血小板计数（PC）、脾脏大小（SS）和门静脉血流（PBF）已在肝硬化患者原位肝移植（OLT）围手术期进行了独立研究，但这些参数尚未结合在一起进行描述和分析。我们分析了 125 例成年患者在OLT 前和移植后 1、3、6、9 和 12 个月的 PC 数据和 SS 和 PBF 的多普勒超声测量值。使用具有固定受试者随机截距的线性混合模型。PC 从 OLT 前的 101.5±68.5×10^9/L 显著增加到 OLT 后 1 个月的 162.4±86×10^9/L，并在手术后 1 年内保持稳定。PBF 从 OLT 前的 619±239mL/min 显著增加到 OLT 后的 1379±491mL/min，并在第一年保持稳定。SS 在 OLT 后缓慢下降，但仅在手术后 9 个月时下降才有统计学意义（OLT 前为 13.8±4.2cm，OLT 后为 11.7±3.7cm，P<0.05）。肝硬化病因并不影响参数的演变。OLT 前是否复制或干扰素治疗，丙型肝炎病毒对术后 PC 均无影响。SS 的演变与移植后 1 年内的 PC 演变相关。总之，PC 和 PBF 在 OLT 后迅速增加，而 SS 则缓慢下降。肝硬化病因不影响 PC 的演变。血小板减少症和脾肿大是门静脉高压的两个结果，但 PBF 的快速正常化并不能完全或迅速逆转这两个现象。
