HIGHER PLATELETS LEVELS IN POSTOPERATIVE ORTHOTOPIC LIVER TRANSPLANT PATIENTS ASSOCIATED WITH HIGHER RATES OF COMPLICATIONS

Document Type

Conference Proceeding

Publication Date

10-25-2023

Publication Title

Hepatology

Abstract

Background: Prior research into the relationship between liver transplant outcomes and platelet levels is limited, but research has shown that peri-operative thrombocytopenia is linked to decreased outcomes and thrombocytopenia on postoperative day 5 have been linked to higher 90-day mortality. However, there is little known about the effect of immediate postoperative thrombocytopenia on long-term morbidity and mortality. The aim of this research was to investigate the relationship between platelet levels immediately posttransplant and one-year postoperative morbidity, including re-hospitalization, rejection, surgical complications, and graft failure, and mortality. Methods: A retrospective chart review was conducted at a diverse, urban transplant center and included 828 adults who underwent orthotopic liver transplant between 2012 and 2022. Data from medical charts including platelet levels, postoperative and surgical complications, platelet infusion history, acute and chronic rejection, graft failure, and death from time of transplant one-year postoperatively was recorded and analyzed. Immediate postoperative platelets levels were defined as platelets levels available closest to transplant surgery end time. To analyze postoperative survival, participants were separated into cohorts based on immediate postop platelet levels (uL): <60,000, 61-90,000, 91-130,000, and >130,000. Results: Average preoperative platelets levels were 99,000 uL (SD =62,000) and average postoperative levels were 77,000 uL (SD = 50,000). Average time from surgery end to measurement of immediate postoperative platelet levels was 37.5 minutes. Contrary to data published thus far, this study showed that higher immediate post-operative platelet levels were found to be associated with a higher chance of readmission (p = 0.046) and acute rejection (p= 0.007). In fact, for every one unit increase in platelets, there was a 0.2% increased risk of readmission and 0.5% increased risk of acute rejection. Overall survival rate was found to be 82.8% and there was no significant difference found between post-op platelet levels and survival rates at one-year (p =0.628). Furthermore, no significant difference was found between postoperative levels and chronic rejection, surgical complications, and graft failure at one year postoperatively. Conclusion: Overall, this study shows that post-operative thrombocytopenia might not be as detrimental to long-term outcomes as previously thought and shows that increased platelets may pose a slight increased risk of complications.

Volume

78

First Page

S315

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