Platelet Counts as Predictors of Short- and Long-Term Outcomes in Liver Transplantation: Cassandras or Just Rats on a Sinking Ship?
1Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Aachen, Germany
2Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen, Germany
3Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands.
Meeting: 2018 American Transplant Congress
Abstract number: A251
Keywords: Liver, Morbidity, Mortality, Thrombocytopenia
Session Information
Session Name: Poster Session A: Liver Retransplantation and Other Complications
Session Type: Poster Session
Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Background
Thrombocytopenia is associated with higher morbidity and mortality following partial hepatectomy and orthotopic liver transplantation (OLT). Here we investigated platelet counts (PC) as a predictor of short- and long-term outcomes following OLT.
Method
322 consecutive patients underwent OLT at our institution (5/2010-6/2017). The area under the receiver operating characteristic curve (AUROC) was used to determine the predictive value of PC for morbidity. 90-day post-OLT complications were graded using the Clavien-Dindo-Score (CD) and quantified using the comprehensive-complication-index (CCI). Parametric and non-parametric tests were applied for subgroup analyses, as appropriate. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of severe complications (CD 3-4). Patient and graft survival were analysed using the Kaplan-Meier method and log-rank test.
Results
Postoperative day 6 (POD-6) PC <105×109/L were identified as the best cut-off for predicting major complications (AUROC=0.7; p<0.001; highest Youden index: 0.275). The stratification of patients into low (n=178) and high platelet (n=107) groups highlighted significant differences in major complications (75% vs. 50%, p<0.001); CCI [55 (IQR 50) vs. 35 (IQR 32), p<0.001); hospital and intensive care unit stays [34 (IQR 36) vs. 23 (IQR 13), p<0.001 // 6 (IQR 13) vs. 3 (IQR 3), p<0.001, respectively). Lower 5-year censored patient and graft survival rates were observed in the low PC group (75% vs. 88%, p=0.013 // 72% vs. 84%, p=0.028, respectively), but these long-term survival differences were lost after excluding patients who died in the first 90 days after OLT. Multivariate regression analysis identified POD-6 PC<105 x109/L as an independent predictor of severe complications [Odds Ratio (OR) 2.384, Confidence Intervals (CI) 1.148-4.949, p=0.02].
Conclusion
This study identified PC<105 x109/L on POD-6 as a potential tool for predicting short-term outcomes following OLT in our cohort.
CITATION INFORMATION: Amygdalos I., Czigany Z., Böcker J., Meister F., Krebbers M., Morales Santana D., Bednarsch J., Schöning W., Ulmer F., Koek G., Kroy D., Tacke F., Trautwein C., Neumann U., Lurje G. Platelet Counts as Predictors of Short- and Long-Term Outcomes in Liver Transplantation: Cassandras or Just Rats on a Sinking Ship? Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Amygdalos I, Czigany Z, Böcker J, Meister F, Krebbers M, Santana DMorales, Bednarsch J, Schöning W, Ulmer F, Koek G, Kroy D, Tacke F, Trautwein C, Neumann U, Lurje G. Platelet Counts as Predictors of Short- and Long-Term Outcomes in Liver Transplantation: Cassandras or Just Rats on a Sinking Ship? [abstract]. https://atcmeetingabstracts.com/abstract/platelet-counts-as-predictors-of-short-and-long-term-outcomes-in-liver-transplantation-cassandras-or-just-rats-on-a-sinking-ship/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress