Effect of severe thrombocytopenia on patient outcome after liver transplantation.

Abstract:

OBJECTIVE:The objective was to identify factors associated with thrombocytopenia and to assess to what extent thrombocytopenia increases bleeding complications in liver transplant patients. DESIGN:Retrospective study. SETTING:Surgical intensive care unit in a university hospital. PATIENTS:One hundred and sixty-one patients admitted to the intensive care unit after liver transplantation. INTERVENTION:None. MEASUREMENTS AND RESULTS:Incidence of thrombocytopenia was defined as a platelet count of <50 x 10(9)/l for at least 3 consecutive days, associated events for thrombocytopenia or bleeding were identified by a Cox proportional hazard analysis, and blood product consumption was studied. Thrombocytopenia occurred in 104 patients (65%) with a mortality rate of 18% compared with 2% in non-thrombocytopenic patients (p=0.002). Independent associated events for thrombocytopenia were need of dialysis (hazard ratio [HR], 2.30; 95% confidence interval (95% CI), 1.10-4.80) and value of preoperative platelet count (HR, 1.06; 95% CI, 1.01-1.12 by 10(4) platelet decrease). The unique associated event identified for significant bleeding was sepsis (HR, 34.80; 95% CI, 1.47-153.40). Severe thrombocytopenia led to an excess of blood product consumption (red blood cells and platelets units) during ICU stay. CONCLUSION:Thrombocytopenia of <50 x 10(9)/l for 3 days is frequent after liver transplantation and as such is not an important contributor to bleeding. However, thrombocytopenia does reflect the severity of the postoperative course.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Ben Hamida C,Lauzet JY,Rézaiguia-Delclaux S,Duvoux C,Cherqui D,Duvaldestin P,Stéphan F

doi

10.1007/s00134-003-1727-x

keywords:

subject

Has Abstract

pub_date

2003-05-01 00:00:00

pages

756-62

issue

5

eissn

0342-4642

issn

1432-1238

journal_volume

29

pub_type

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