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Thrombopoietin in postoperative thrombocytopenia following living donor hepatectomy.

Abstract
Thrombocytopenia is a frequent finding following living donor hepatectomy. It appears more pronounced in right graft donors than in left graft donors. This study analyzed postoperative thrombocytopenia in 20 living liver donors and examined the change of endogenous thrombopoietin (TPO) in its recovery. Platelet count, TPO level, fibrinogen degradation product (FDP), and D-Dimer were measured before surgery and on postoperative days (PODs) 1, 2, 3, 5, 7, and 14. Concurrently, liver and spleen volumes were calculated by computed tomography. Platelet count on POD 3 was significantly lower in right graft donors than in left graft donors (13.0 +/- 3.7 x 10(4)/microL vs. 16.8 +/- 4.0 x 10(4)/microL, P = 0.039) but recovered by POD 7 in all donors. Postoperative elevations of FDP and D-Dimer were significantly higher in right graft donors than in left graft donors. TPO level rose immediately after surgery, peaked on POD 5 in left graft donors and on POD 7 in right graft donors, and fell nearly to preoperative levels by POD 14. Postoperative TPO level per liver volume was significantly higher in right graft donors than in left graft donors. In conclusion, thrombocytopenia following living donor hepatectomy resolved within the first week regardless of graft type and was mainly associated with increasing consumption of circulating platelets, possibly due to intrahepatic and splenic congestion. With a reduced number of circulating platelets, TPO level rapidly increases. Also, with reduced consumption of platelets related to recovery from surgery, thrombocytopenia should resolve. As a consequence, TPO level would be expected to fall.
AuthorsYoshihide Nagasako, Meang Bong Jin, Hiroshi Miyazaki, Masato Nakayama, Tsuyoshi Shimamura, Hiroyuki Furukawa, Michiaki Matushita, Satoru Todo
JournalLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society (Liver Transpl) Vol. 12 Issue 3 Pg. 435-9 (Mar 2006) ISSN: 1527-6465 [Print] United States
PMID16498650 (Publication Type: Comparative Study, Journal Article)
CopyrightCopyright 2006 AASLD
Chemical References
  • Biomarkers
  • Thrombopoietin
Topics
  • Adult
  • Biomarkers (blood)
  • Chi-Square Distribution
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hepatectomy (adverse effects, methods)
  • Humans
  • Liver Transplantation (methods)
  • Living Donors
  • Male
  • Middle Aged
  • Postoperative Complications (blood, diagnosis)
  • Probability
  • Sensitivity and Specificity
  • Thrombocytopenia (diagnosis, etiology)
  • Thrombopoietin (blood, metabolism)

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