BACKGROUND: Platelet transfusions have been identified as an independent risk factor for survival after orthotopic liver transplantation (OLT). In this study, we analyzed the specific causes of mortality and graft loss in relation to platelet transfusions during OLT. METHODS: In a series of 449 consecutive adult patients undergoing a first OLT, the causes of patient death and graft failure were studied in patients who did or did not receive perioperative platelet transfusions. RESULTS: Patient and graft survival were significantly reduced in patients who received platelet transfusions, compared with those who did not (74% vs 92%, and 69% vs 85%, respectively at 1 yr; P < 0.001). Lower survival rates in patients who received platelets were attributed to a significantly higher rate of early mortality because of acute lung injury (4.4% vs 0.4%; P = 0.004). There were no significant differences in other causes of mortality between the two groups. The main cause of graft loss in patients receiving platelets was patient death with a functioning graft. CONCLUSIONS: These findings suggest that platelet transfusions are an important risk factor for mortality after OLT. The current study extends previous observations by identifying acute lung injury as the main determinant of increased mortality. The higher rate of graft loss in patients receiving platelets is related to the higher overall mortality rate and does not result from specific adverse effects of transfused platelets on the grafted liver.
BACKGROUND: Platelet transfusions have been identified as an independent risk factor for survival after orthotopic liver transplantation (OLT). In this study, we analyzed the specific causes of mortality and graft loss in relation to platelet transfusions during OLT. METHODS: In a series of 449 consecutive adult patients undergoing a first OLT, the causes of patientdeath and graft failure were studied in patients who did or did not receive perioperative platelet transfusions. RESULTS:Patient and graft survival were significantly reduced in patients who received platelet transfusions, compared with those who did not (74% vs 92%, and 69% vs 85%, respectively at 1 yr; P < 0.001). Lower survival rates in patients who received platelets were attributed to a significantly higher rate of early mortality because of acute lung injury (4.4% vs 0.4%; P = 0.004). There were no significant differences in other causes of mortality between the two groups. The main cause of graft loss in patients receiving platelets was patient death with a functioning graft. CONCLUSIONS: These findings suggest that platelet transfusions are an important risk factor for mortality after OLT. The current study extends previous observations by identifying acute lung injury as the main determinant of increased mortality. The higher rate of graft loss in patients receiving platelets is related to the higher overall mortality rate and does not result from specific adverse effects of transfused platelets on the grafted liver.
Authors: Benedikt Reichert; Alexander Kaltenborn; Thomas Becker; Mario Schiffer; Jürgen Klempnauer; Harald Schrem Journal: Langenbecks Arch Surg Date: 2014-03-30 Impact factor: 3.445
Authors: Alexander B Benson; James R Burton; Gregory L Austin; Scott W Biggins; Michael A Zimmerman; Igal Kam; Susan Mandell; Christopher C Silliman; Hugo Rosen; Marc Moss Journal: Liver Transpl Date: 2011-02 Impact factor: 5.799
Authors: Paolo Feltracco; Cristiana Carollo; Stefania Barbieri; Tommaso Pettenuzzo; Carlo Ori Journal: World J Gastroenterol Date: 2013-12-28 Impact factor: 5.742
Authors: Paolo Feltracco; Marialuisa Brezzi; Stefania Barbieri; Helmut Galligioni; Moira Milevoj; Cristiana Carollo; Carlo Ori Journal: World J Hepatol Date: 2013-01-27
Authors: J J Vos; T W L Scheeren; D J Lukes; M T de Boer; H G D Hendriks; J K G Wietasch Journal: J Clin Monit Comput Date: 2013-05-16 Impact factor: 2.502