Immediate Postoperative Low Platelet Counts After Living Donor Liver Transplantation Predict Early Allograft Dysfunction

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(9)/L and High Platelet Group (128 patients) with platelet >68 × 10(9)/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(9)/L is an independent risk factor for EAD. Platelet maybe influences the functional status of the liver by promoting graft regeneration after liver transplantation.