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Thrombocytopenia after liver transplantation: Should we care?

Transient thrombocytopenia is a common phenomenon after liver transplantation. After liver transplantation (LT), platelet count decreases and reaches a nadir on postoperative days 3-5, with an average reduction in platelet counts of 60%; platelet count recovers to preoperative levels approximately t...

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Autores principales: Takahashi, Kazuhiro, Nagai, Shunji, Safwan, Mohamed, Liang, Chen, Ohkohchi, Nobuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889819/
https://www.ncbi.nlm.nih.gov/pubmed/29632420
http://dx.doi.org/10.3748/wjg.v24.i13.1386
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author Takahashi, Kazuhiro
Nagai, Shunji
Safwan, Mohamed
Liang, Chen
Ohkohchi, Nobuhiro
author_facet Takahashi, Kazuhiro
Nagai, Shunji
Safwan, Mohamed
Liang, Chen
Ohkohchi, Nobuhiro
author_sort Takahashi, Kazuhiro
collection PubMed
description Transient thrombocytopenia is a common phenomenon after liver transplantation. After liver transplantation (LT), platelet count decreases and reaches a nadir on postoperative days 3-5, with an average reduction in platelet counts of 60%; platelet count recovers to preoperative levels approximately two weeks after LT. The putative mechanisms include haemodilution, decreased platelet production, increased sequestration, medications, infections, thrombosis, or combination of these processes. However, the precise mechanisms remain unclear. The role of platelets in liver transplantation has been highlighted in recent years, and particular attention has been given to their effects beyond hemostasis and thrombosis. Previous studies have demonstrated that perioperative thrombocytopenia causes poor graft regeneration, increases the incidence of postoperative morbidity, and deteriorates the graft and decreases patient survival in both the short and long term after liver transplantation. Platelet therapies to increase perioperative platelet counts, such as thrombopoietin, thrombopoietin receptor agonist, platelet transfusion, splenectomy, and intravenous immunoglobulin treatment might have a potential for improving graft survival, however clinical trials are lacking. Further studies are warranted to detect direct evidence on whether thrombocytopenia is the cause or result of poor-graft function and postoperative complications, and to determine who needs platelet therapies in order to prevent postoperative complications and thus improve post-transplant outcomes.
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spelling pubmed-58898192018-04-09 Thrombocytopenia after liver transplantation: Should we care? Takahashi, Kazuhiro Nagai, Shunji Safwan, Mohamed Liang, Chen Ohkohchi, Nobuhiro World J Gastroenterol Minireviews Transient thrombocytopenia is a common phenomenon after liver transplantation. After liver transplantation (LT), platelet count decreases and reaches a nadir on postoperative days 3-5, with an average reduction in platelet counts of 60%; platelet count recovers to preoperative levels approximately two weeks after LT. The putative mechanisms include haemodilution, decreased platelet production, increased sequestration, medications, infections, thrombosis, or combination of these processes. However, the precise mechanisms remain unclear. The role of platelets in liver transplantation has been highlighted in recent years, and particular attention has been given to their effects beyond hemostasis and thrombosis. Previous studies have demonstrated that perioperative thrombocytopenia causes poor graft regeneration, increases the incidence of postoperative morbidity, and deteriorates the graft and decreases patient survival in both the short and long term after liver transplantation. Platelet therapies to increase perioperative platelet counts, such as thrombopoietin, thrombopoietin receptor agonist, platelet transfusion, splenectomy, and intravenous immunoglobulin treatment might have a potential for improving graft survival, however clinical trials are lacking. Further studies are warranted to detect direct evidence on whether thrombocytopenia is the cause or result of poor-graft function and postoperative complications, and to determine who needs platelet therapies in order to prevent postoperative complications and thus improve post-transplant outcomes. Baishideng Publishing Group Inc 2018-04-07 2018-04-07 /pmc/articles/PMC5889819/ /pubmed/29632420 http://dx.doi.org/10.3748/wjg.v24.i13.1386 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Minireviews
Takahashi, Kazuhiro
Nagai, Shunji
Safwan, Mohamed
Liang, Chen
Ohkohchi, Nobuhiro
Thrombocytopenia after liver transplantation: Should we care?
title Thrombocytopenia after liver transplantation: Should we care?
title_full Thrombocytopenia after liver transplantation: Should we care?
title_fullStr Thrombocytopenia after liver transplantation: Should we care?
title_full_unstemmed Thrombocytopenia after liver transplantation: Should we care?
title_short Thrombocytopenia after liver transplantation: Should we care?
title_sort thrombocytopenia after liver transplantation: should we care?
topic Minireviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889819/
https://www.ncbi.nlm.nih.gov/pubmed/29632420
http://dx.doi.org/10.3748/wjg.v24.i13.1386
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