Low immediate postoperative platelet count is associated with hepatic insufficiency after hepatectomy.

Abstract

AIM:

To investigate the relationship between low immediate postoperative platelet count and perioperative outcome after liver resection in patients with hepatocellular carcinoma (HCC).

METHODS:

In a cohort of 565 consecutive hepatitis B-related HCC patients who underwent major liver resection, the characteristics and clinical outcomes after liver resection were compared between patients with immediate postoperative platelet count < 100 × 10(9)/L and patients with platelet count ≥ 100 × 10(9)/L. Risk factors for postoperative hepatic insufficiency were evaluated by multivariate analysis.

RESULTS:

Patients with a low immediate postoperative platelet count (< 100 × 10(9)/L) had more grade III-V complications (20.5% vs 12.4%, P = 0.016), and higher rates of postoperative liver failure (6.8% vs 2.6%, P = 0.02), hepatic insufficiency (31.5% vs 21.2%, P < 0.001) and mortality (6.8% vs 0.5%, P < 0.001), compared to patients with a platelet count ≥ 100 × 10(9)/L. The alanine aminotransferase levels on postoperative days 3 and 5, and bilirubin on postoperative days 1, 3 and 5 were higher in patients with immediate postoperative low platelet count. Multivariate analysis revealed that immediate postoperative low platelet count, rather than preoperative low platelet count, was a significant independent risk factor for hepatic insufficiency.

CONCLUSION:

A low immediate postoperative platelet count is an independent risk factor for hepatic insufficiency. Platelets can mediate liver regeneration in the cirrhotic liver.

• Authors: Hai-Qing Wang, Jian Yang, Jia-Yin Yang, Wen-Tao Wang, Lu-Nan Yan
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 20 Issue 33 Pg. 11871-7 (Sep 07 2014) ISSN: 2219-2840 [Electronic] United States
• PMID: 25206294 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• Alanine Transaminase
• Bilirubin

Topics

• Aged
• Alanine Transaminase (blood)
• Bilirubin (blood)
• Biomarkers (blood)
• Carcinoma, Hepatocellular (mortality, surgery)
• Chi-Square Distribution
• Female
• Hepatectomy (adverse effects, mortality)
• Hepatic Insufficiency (blood, diagnosis, etiology, mortality)
• Humans
• Liver Failure (blood, etiology)
• Liver Neoplasms (mortality, surgery)
• Liver Regeneration
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Platelet Count
• Predictive Value of Tests
• Risk Factors
• Thrombocytopenia (blood, diagnosis, etiology, mortality)
• Time Factors
• Treatment Outcome