Prognostic impact of postoperative low platelet count after liver transplantation
Background The positive impact of platelets has been recently implicated in liver transplantation (LT). The aim of this study was to determine the risk factors for graft loss and mortality after LT, focusing on perioperative platelet counts. Methods We reviewed all deceased donor LT from 2000 to 201...
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| Veröffentlicht in: | Clinical transplantation 2017-03, Vol.31 (3), p.np-n/a |
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| creator | Takahashi, Kazuhiro Nagai, Shunji Putchakayala, Krishna G. Safwan, Mohamed Li, Amy Y. Kane, William J. Singh, Priyanka L. Collins, Kelly M. Rizzari, Michael D. Yoshida, Atsushi Schnickel, Gabriel T. Abouljoud, Marwan S. |
| description | Background
The positive impact of platelets has been recently implicated in liver transplantation (LT). The aim of this study was to determine the risk factors for graft loss and mortality after LT, focusing on perioperative platelet counts.
Methods
We reviewed all deceased donor LT from 2000 to 2012 and enrolled 975 consecutive recipients. The risk factors for graft loss and mortality were analyzed by multivariate analysis, using Cox's regression model.
Results
Using cutoff values acquired by receiver operating characteristics curve analysis, multivariate analyses determined that viral hepatitis C (hazard ratio [HR]=1.32), donor age >40 (HR=1.33), higher peak serum alanine aminotransferase (HR=1.01), reoperation within 30 days (HR=1.51), and platelet count |
| doi_str_mv | 10.1111/ctr.12891 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1877814990</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1851290402</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4241-d58b576227733eb510bec6afc5ad01ef30ee4dfb98f0af3532b09a7d6f2afb0d3</originalsourceid><addsrcrecordid>eNqNkEtLAzEUhYMotj4W_gHJUhfT5jGvLKX4goIP6jpkMjcyMjMZk9TSf290qjvBu7mXcz4Ol4PQGSUzGmeug5tRVgq6h6aUC5EQQtk-mhJBWLxzPkFH3r9FNad5dogmrBCC5XkxRU-Pzr721odG46YblA7YGjxEwQ7gVGg-ALd2g4dWBWghYG3XfcDKBHC4ja7DwaneR78PEbf9CTowqvVwutvH6OXmerW4S5YPt_eLq2WiU5bSpM7KKityxoqCc6gySirQuTI6UzWhYDgBSGtTidIQZXjGWUWEKurcMGUqUvNjdDHmDs6-r8EH2TVeQxsfAbv2kpZFUdJUCPIPNKNMkJSwiF6OqHbWewdGDq7plNtKSuRX2TKWLb_Ljuz5LnZddVD_kj_tRmA-Apumhe3fSXKxeh4jPwHSwYqD</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1851290402</pqid></control><display><type>article</type><title>Prognostic impact of postoperative low platelet count after liver transplantation</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Takahashi, Kazuhiro ; Nagai, Shunji ; Putchakayala, Krishna G. ; Safwan, Mohamed ; Li, Amy Y. ; Kane, William J. ; Singh, Priyanka L. ; Collins, Kelly M. ; Rizzari, Michael D. ; Yoshida, Atsushi ; Schnickel, Gabriel T. ; Abouljoud, Marwan S.</creator><creatorcontrib>Takahashi, Kazuhiro ; Nagai, Shunji ; Putchakayala, Krishna G. ; Safwan, Mohamed ; Li, Amy Y. ; Kane, William J. ; Singh, Priyanka L. ; Collins, Kelly M. ; Rizzari, Michael D. ; Yoshida, Atsushi ; Schnickel, Gabriel T. ; Abouljoud, Marwan S.</creatorcontrib><description>Background
The positive impact of platelets has been recently implicated in liver transplantation (LT). The aim of this study was to determine the risk factors for graft loss and mortality after LT, focusing on perioperative platelet counts.
Methods
We reviewed all deceased donor LT from 2000 to 2012 and enrolled 975 consecutive recipients. The risk factors for graft loss and mortality were analyzed by multivariate analysis, using Cox's regression model.
Results
Using cutoff values acquired by receiver operating characteristics curve analysis, multivariate analyses determined that viral hepatitis C (hazard ratio [HR]=1.32), donor age >40 (HR=1.33), higher peak serum alanine aminotransferase (HR=1.01), reoperation within 30 days (HR=1.51), and platelet count <72 500/μL on postoperative day (POD) 5 (HR=1.30) were independent risk factors for graft loss. Viral hepatitis C (HR=1.33), reoperation within 30 days (HR=1.35), and platelet count <72 500/μL on POD 5 (HR=1.38) were independent risk factors for mortality.
Conclusion
A low platelet count on POD 5 was associated with graft loss and mortality after LT. Platelet count <72 500/μL on POD 5 can be a predictor of poor graft and overall survival. Maintaining higher postoperative platelet counts could potentially improve graft and overall survival rates.</description><identifier>ISSN: 0902-0063</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/ctr.12891</identifier><identifier>PMID: 27992667</identifier><language>eng</language><publisher>Denmark</publisher><subject>Adult ; Female ; Follow-Up Studies ; Graft Rejection - blood ; Graft Rejection - etiology ; Graft Rejection - pathology ; Graft Survival ; Hepatitis C virus ; Humans ; liver transplantation ; Liver Transplantation - adverse effects ; Male ; Middle Aged ; overall survival ; platelet ; Platelet Count ; Postoperative Complications ; Prognosis ; Risk Factors ; Survival Rate ; thrombocytopenia ; Thrombocytopenia - blood ; Thrombocytopenia - etiology ; Thrombocytopenia - pathology</subject><ispartof>Clinical transplantation, 2017-03, Vol.31 (3), p.np-n/a</ispartof><rights>2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4241-d58b576227733eb510bec6afc5ad01ef30ee4dfb98f0af3532b09a7d6f2afb0d3</citedby><cites>FETCH-LOGICAL-c4241-d58b576227733eb510bec6afc5ad01ef30ee4dfb98f0af3532b09a7d6f2afb0d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fctr.12891$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fctr.12891$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27992667$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takahashi, Kazuhiro</creatorcontrib><creatorcontrib>Nagai, Shunji</creatorcontrib><creatorcontrib>Putchakayala, Krishna G.</creatorcontrib><creatorcontrib>Safwan, Mohamed</creatorcontrib><creatorcontrib>Li, Amy Y.</creatorcontrib><creatorcontrib>Kane, William J.</creatorcontrib><creatorcontrib>Singh, Priyanka L.</creatorcontrib><creatorcontrib>Collins, Kelly M.</creatorcontrib><creatorcontrib>Rizzari, Michael D.</creatorcontrib><creatorcontrib>Yoshida, Atsushi</creatorcontrib><creatorcontrib>Schnickel, Gabriel T.</creatorcontrib><creatorcontrib>Abouljoud, Marwan S.</creatorcontrib><title>Prognostic impact of postoperative low platelet count after liver transplantation</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>Background
The positive impact of platelets has been recently implicated in liver transplantation (LT). The aim of this study was to determine the risk factors for graft loss and mortality after LT, focusing on perioperative platelet counts.
Methods
We reviewed all deceased donor LT from 2000 to 2012 and enrolled 975 consecutive recipients. The risk factors for graft loss and mortality were analyzed by multivariate analysis, using Cox's regression model.
Results
Using cutoff values acquired by receiver operating characteristics curve analysis, multivariate analyses determined that viral hepatitis C (hazard ratio [HR]=1.32), donor age >40 (HR=1.33), higher peak serum alanine aminotransferase (HR=1.01), reoperation within 30 days (HR=1.51), and platelet count <72 500/μL on postoperative day (POD) 5 (HR=1.30) were independent risk factors for graft loss. Viral hepatitis C (HR=1.33), reoperation within 30 days (HR=1.35), and platelet count <72 500/μL on POD 5 (HR=1.38) were independent risk factors for mortality.
Conclusion
A low platelet count on POD 5 was associated with graft loss and mortality after LT. Platelet count <72 500/μL on POD 5 can be a predictor of poor graft and overall survival. Maintaining higher postoperative platelet counts could potentially improve graft and overall survival rates.</description><subject>Adult</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft Rejection - blood</subject><subject>Graft Rejection - etiology</subject><subject>Graft Rejection - pathology</subject><subject>Graft Survival</subject><subject>Hepatitis C virus</subject><subject>Humans</subject><subject>liver transplantation</subject><subject>Liver Transplantation - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>overall survival</subject><subject>platelet</subject><subject>Platelet Count</subject><subject>Postoperative Complications</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><subject>thrombocytopenia</subject><subject>Thrombocytopenia - blood</subject><subject>Thrombocytopenia - etiology</subject><subject>Thrombocytopenia - pathology</subject><issn>0902-0063</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkEtLAzEUhYMotj4W_gHJUhfT5jGvLKX4goIP6jpkMjcyMjMZk9TSf290qjvBu7mXcz4Ol4PQGSUzGmeug5tRVgq6h6aUC5EQQtk-mhJBWLxzPkFH3r9FNad5dogmrBCC5XkxRU-Pzr721odG46YblA7YGjxEwQ7gVGg-ALd2g4dWBWghYG3XfcDKBHC4ja7DwaneR78PEbf9CTowqvVwutvH6OXmerW4S5YPt_eLq2WiU5bSpM7KKityxoqCc6gySirQuTI6UzWhYDgBSGtTidIQZXjGWUWEKurcMGUqUvNjdDHmDs6-r8EH2TVeQxsfAbv2kpZFUdJUCPIPNKNMkJSwiF6OqHbWewdGDq7plNtKSuRX2TKWLb_Ljuz5LnZddVD_kj_tRmA-Apumhe3fSXKxeh4jPwHSwYqD</recordid><startdate>201703</startdate><enddate>201703</enddate><creator>Takahashi, Kazuhiro</creator><creator>Nagai, Shunji</creator><creator>Putchakayala, Krishna G.</creator><creator>Safwan, Mohamed</creator><creator>Li, Amy Y.</creator><creator>Kane, William J.</creator><creator>Singh, Priyanka L.</creator><creator>Collins, Kelly M.</creator><creator>Rizzari, Michael D.</creator><creator>Yoshida, Atsushi</creator><creator>Schnickel, Gabriel T.</creator><creator>Abouljoud, Marwan S.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>201703</creationdate><title>Prognostic impact of postoperative low platelet count after liver transplantation</title><author>Takahashi, Kazuhiro ; Nagai, Shunji ; Putchakayala, Krishna G. ; Safwan, Mohamed ; Li, Amy Y. ; Kane, William J. ; Singh, Priyanka L. ; Collins, Kelly M. ; Rizzari, Michael D. ; Yoshida, Atsushi ; Schnickel, Gabriel T. ; Abouljoud, Marwan S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4241-d58b576227733eb510bec6afc5ad01ef30ee4dfb98f0af3532b09a7d6f2afb0d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft Rejection - blood</topic><topic>Graft Rejection - etiology</topic><topic>Graft Rejection - pathology</topic><topic>Graft Survival</topic><topic>Hepatitis C virus</topic><topic>Humans</topic><topic>liver transplantation</topic><topic>Liver Transplantation - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>overall survival</topic><topic>platelet</topic><topic>Platelet Count</topic><topic>Postoperative Complications</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><topic>thrombocytopenia</topic><topic>Thrombocytopenia - blood</topic><topic>Thrombocytopenia - etiology</topic><topic>Thrombocytopenia - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takahashi, Kazuhiro</creatorcontrib><creatorcontrib>Nagai, Shunji</creatorcontrib><creatorcontrib>Putchakayala, Krishna G.</creatorcontrib><creatorcontrib>Safwan, Mohamed</creatorcontrib><creatorcontrib>Li, Amy Y.</creatorcontrib><creatorcontrib>Kane, William J.</creatorcontrib><creatorcontrib>Singh, Priyanka L.</creatorcontrib><creatorcontrib>Collins, Kelly M.</creatorcontrib><creatorcontrib>Rizzari, Michael D.</creatorcontrib><creatorcontrib>Yoshida, Atsushi</creatorcontrib><creatorcontrib>Schnickel, Gabriel T.</creatorcontrib><creatorcontrib>Abouljoud, Marwan S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takahashi, Kazuhiro</au><au>Nagai, Shunji</au><au>Putchakayala, Krishna G.</au><au>Safwan, Mohamed</au><au>Li, Amy Y.</au><au>Kane, William J.</au><au>Singh, Priyanka L.</au><au>Collins, Kelly M.</au><au>Rizzari, Michael D.</au><au>Yoshida, Atsushi</au><au>Schnickel, Gabriel T.</au><au>Abouljoud, Marwan S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic impact of postoperative low platelet count after liver transplantation</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2017-03</date><risdate>2017</risdate><volume>31</volume><issue>3</issue><spage>np</spage><epage>n/a</epage><pages>np-n/a</pages><issn>0902-0063</issn><eissn>1399-0012</eissn><abstract>Background
The positive impact of platelets has been recently implicated in liver transplantation (LT). The aim of this study was to determine the risk factors for graft loss and mortality after LT, focusing on perioperative platelet counts.
Methods
We reviewed all deceased donor LT from 2000 to 2012 and enrolled 975 consecutive recipients. The risk factors for graft loss and mortality were analyzed by multivariate analysis, using Cox's regression model.
Results
Using cutoff values acquired by receiver operating characteristics curve analysis, multivariate analyses determined that viral hepatitis C (hazard ratio [HR]=1.32), donor age >40 (HR=1.33), higher peak serum alanine aminotransferase (HR=1.01), reoperation within 30 days (HR=1.51), and platelet count <72 500/μL on postoperative day (POD) 5 (HR=1.30) were independent risk factors for graft loss. Viral hepatitis C (HR=1.33), reoperation within 30 days (HR=1.35), and platelet count <72 500/μL on POD 5 (HR=1.38) were independent risk factors for mortality.
Conclusion
A low platelet count on POD 5 was associated with graft loss and mortality after LT. Platelet count <72 500/μL on POD 5 can be a predictor of poor graft and overall survival. Maintaining higher postoperative platelet counts could potentially improve graft and overall survival rates.</abstract><cop>Denmark</cop><pmid>27992667</pmid><doi>10.1111/ctr.12891</doi><tpages>8</tpages></addata></record> |
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| ispartof | Clinical transplantation, 2017-03, Vol.31 (3), p.np-n/a |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Female Follow-Up Studies Graft Rejection - blood Graft Rejection - etiology Graft Rejection - pathology Graft Survival Hepatitis C virus Humans liver transplantation Liver Transplantation - adverse effects Male Middle Aged overall survival platelet Platelet Count Postoperative Complications Prognosis Risk Factors Survival Rate thrombocytopenia Thrombocytopenia - blood Thrombocytopenia - etiology Thrombocytopenia - pathology |
| title | Prognostic impact of postoperative low platelet count after liver transplantation |
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