Li Qingshan, Wang Yue, Ma Tao, Ren Fenggang, Mu Fan, Wu Rongqian, Lv Yi, Wang Bo
National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, Institute of Advanced Surgical Technology and Engineering, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, Xi'an, 710061, Shaanxi Province, China.
Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
BMC Gastroenterol. 2021 Jan 6;21(1):1. doi: 10.1186/s12876-020-01553-z.
The role of platelets on the prognosis of patients with liver transplantation remains unclear. Thus, we aimed to evaluate the influence of preoperative platelet count on postoperative morbidity after liver transplantation.
Clinical data of the patients who received liver transplantation from January 2015 to September 2018 were evaluated.
Of the 329 patients included, the average age was 46.71 ± 0.55 years, and 243 were men (75.2%). The incidence of posttransplant portal vein complication was significantly higher in the high platelet count group (> 49.5 × 10/L; n = 167) than in the low platelet count group (≤ 49.5 × 10/L, n = 162, 12.6% vs. 1.9%). After multivariable regression analysis, high platelet count was independently associated with postoperative portal vein complication (odds ratio [OR]: 8.821, 95% confidence interval [CI]: 2.260 to 34.437). After the inverse probability of treatment weighting analysis, patients in the high platelet count group had significantly higher risk of portal vein complication (OR: 9.210, 95%CI: 1.907 to 44.498, p = 0.006) and early allograft dysfunction (OR: 2.087, 95%CI: 1.131 to 3.853, p = 0.019).
Preoperative platelet count > 49.5 × 10/L was an independent risk factor for posttransplant portal vein complication and early allograft dysfunction. High preoperative platelet count could be an adverse prognostic predictor for liver transplantation recipients.
血小板在肝移植患者预后中的作用仍不明确。因此，我们旨在评估术前血小板计数对肝移植术后发病率的影响。
对2015年1月至2018年9月接受肝移植的患者的临床资料进行评估。
纳入的329例患者中，平均年龄为46.71±0.55岁，男性243例（75.2%）。高血小板计数组（>49.5×10⁹/L；n = 167）移植后门静脉并发症的发生率显著高于低血小板计数组（≤49.5×10⁹/L，n = 162，12.6%对1.9%）。多变量回归分析后，高血小板计数与术后门静脉并发症独立相关（比值比[OR]：8.821，95%置信区间[CI]：2.260至34.437）。经过治疗权重逆概率分析，高血小板计数组患者发生门静脉并发症的风险显著更高（OR：9.210，95%CI：1.907至44.498，p = 0.006）以及早期移植物功能障碍（OR：2.087，95%CI：1.131至3.853，p = 0.019）。
术前血小板计数>49.5×10⁹/L是移植后门静脉并发症和早期移植物功能障碍的独立危险因素。术前高血小板计数可能是肝移植受者不良预后的预测指标。
