Li Lei, Wang Haiqing, Yang Jian, Jiang Li, Yang Jiayin, Wang Wentao, Yan Lvnan, Wen Tianfu, Li Bo, Xu Mingqing
From the Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China (LL, JY, LJ, JY, WW, LY, TW, BL, MX); and Department of Hepato-Biliary-Pancreatic Surgery, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China (HW).
Medicine (Baltimore). 2015 Aug;94(34):e1373. doi: 10.1097/MD.0000000000001373.
To investigate whether the platelets can improve liver function by mediating liver regeneration. Using a retrospective cohort with 234 consecutive adult-to-adult living donor liver transplantation recipients, we have discussed the relationship between immediate postoperative platelet count and outcome. Patients have been stratified into Low Platelet Group (106 patients) with platelet ≤68 × 10/L and High Platelet Group (128 patients) with platelet >68 × 10/L.Low Platelet Group has a higher rate of preoperative thrombocytopenia (90.6% vs. 32.8%, P<0.001), higher model for end-stage liver disease score (15 vs. 11, P<0.001), cirrhosis (86.8% vs. 76.6%, P=0.046), hepatorenal syndrome (18.2% vs. 4.0%, P=0.005) and fulminant hepatic failure (26.4% vs. 7.8%, P<0.001). The packed red blood cells transfusion (7.5 vs. 5, P = 0.023) and plasma transfusion (1275 mL vs. 800 mL, P=0.001) are more in patients with low platelet count. Low Platelet Group has a higher early allograft dysfunction (EAD) (22.6% vs. 7.0%, P=0.001) and severe complications (22.6% vs. 10.9%, P = 0.016). The 90-day mortality between the 2 groups is similar. The multivariate analysis has found that postoperative platelet ≤68 × 10/L is an independent risk factor for EAD.Platelet maybe influences the functional status of the liver by promoting graft regeneration after liver transplantation.
为研究血小板是否可通过介导肝再生来改善肝功能。我们采用了一个包含234例连续的成人对成人活体肝移植受者的回顾性队列，探讨了术后即刻血小板计数与预后之间的关系。患者被分为血小板≤68×10⁹/L的低血小板组（106例）和血小板>68×10⁹/L的高血小板组（128例）。低血小板组术前血小板减少症发生率更高（90.6%对32.8%，P<0.001），终末期肝病评分更高（15对11，P<0.001），肝硬化发生率更高（86.8%对76.6%，P=0.046），肝肾综合征发生率更高（18.2%对4.0%，P=0.005）以及暴发性肝衰竭发生率更高（26.4%对7.8%，P<0.001）。低血小板计数患者的红细胞输注量更多（7.5对5，P=0.023），血浆输注量更多（1275 mL对800 mL，P=0.001）。低血小板组早期移植物功能障碍（EAD）发生率更高（22.6%对7.0%，P=0.001），严重并发症发生率更高（22.6%对10.9%，P=0.016）。两组之间的90天死亡率相似。多因素分析发现，术后血小板≤68×10⁹/L是EAD的独立危险因素。血小板可能通过促进肝移植后移植物再生来影响肝脏的功能状态。
