Han S, Ko J S, Gwak M S, Kim G S
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Transplant Proc. 2018 May;50(4):1104-1107. doi: 10.1016/j.transproceed.2018.02.035.
We recently showed that platelet counts and the amount of platelet transfusion during liver transplantation are positively associated with early graft regeneration. It was hypothesized that platelet-derived serotonin mediates liver regeneration.
This study aimed to evaluate the association between intraoperative platelet count, platelet transfusion, and serum serotonin level.
Thirty-two recipients undergoing living-donor liver transplantation were enrolled into this prospective observational study. Serum platelet counts and serotonin levels were measured at the following times: anesthetic induction, start of the anhepatic phase, before graft reperfusion, 5 minutes/1 hour/3 hours/5 hours after graft reperfusion, and before/after platelet transfusion. Serotonin was measured by using a liquid chromatography tandem mass spectrometry.
Serotonin level at the anesthetic induction was 24.5 μg/mL (interquartile range, 14.6 to 38.1 μg/mL). During surgery, serial changes in platelet counts and serotonin levels showed a similar trend: they decreased during the anhepatic phase, increased during the first hour after graft reperfusion, and thereafter gradually decreased. Serotonin level was positively correlated with platelet counts (correlation coefficient = 0.620, P < .001). Allogeneic platelet transfusion significantly increased platelet count from 22 (19-31) × 10/L to 53 (50-81) × 10/L (P = .008) and it also increased serum serotonin from 11.04 (6.41-15.34) μg/mL to 34.26 (25.86-41.94) μg/mL (P = .008).
Our findings indicate that allogeneic platelets could act as effector cells deriving serotonins. Also, our findings support the hypothesis that the association between platelets and post-transplantation graft regeneration is mediated by serotonin. Further studies are warranted regarding the respective role of serotonin and other platelet-derived molecules mediating liver regeneration.
我们最近发现，肝移植期间的血小板计数及血小板输注量与早期移植物再生呈正相关。据推测，血小板衍生的血清素介导肝再生。
本研究旨在评估术中血小板计数、血小板输注与血清血清素水平之间的关联。
32例接受活体肝移植的受者纳入了这项前瞻性观察研究。在以下时间点测量血清血小板计数和血清素水平：麻醉诱导时、无肝期开始时、移植肝再灌注前、移植肝再灌注后5分钟/1小时/3小时/5小时，以及血小板输注前后。采用液相色谱串联质谱法测量血清素。
麻醉诱导时血清素水平为24.5μg/mL（四分位间距为14.6至38.1μg/mL）。手术期间，血小板计数和血清素水平的系列变化呈现相似趋势：在无肝期降低，在移植肝再灌注后第1小时升高，此后逐渐降低。血清素水平与血小板计数呈正相关（相关系数=0.620，P<0.001）。异体血小板输注使血小板计数从22（19-31）×10/L显著增加至53（50-81）×10/L（P=0.008），同时也使血清血清素从11.04（6.41-15.34）μg/mL增加至34.26（25.86-41.94）μg/mL（P=0.008）。
我们的研究结果表明，异体血小板可作为血清素的效应细胞。此外，我们的研究结果支持血小板与移植后移植物再生之间的关联由血清素介导这一假说。关于血清素及其他血小板衍生分子在介导肝再生中的各自作用，有必要开展进一步研究。
