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Effect of severe thrombocytopenia on patient outcome after liver transplantation

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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 <50×109/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 nonthrombocytopenic 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 104 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 <50×109/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.

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Authors and Affiliations

  1. Département d'Anesthésie-Réanimation chirurgicale, AP-HP Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France

    Chaker Ben Hamida, Jean-Yves Lauzet, Saida Rézaiguia-Delclaux, Philippe Duvaldestin & François Stéphan

  2. Service d'Hépato-Gastroentérologie, AP-HP Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France

    Christophe Duvoux

  3. Service de Chirurgie digestive, AP-HP Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France

    Daniel Cherqui

Authors
  1. Chaker Ben Hamida
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  2. Jean-Yves Lauzet
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  3. Saida Rézaiguia-Delclaux
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  4. Christophe Duvoux
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  5. Daniel Cherqui
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  7. François Stéphan
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Correspondence to François Stéphan.

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Ben Hamida, C., Lauzet, JY., Rézaiguia-Delclaux, S. et al. Effect of severe thrombocytopenia on patient outcome after liver transplantation. Intensive Care Med 29, 756–762 (2003). https://doi.org/10.1007/s00134-003-1727-x

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  • DOI: https://doi.org/10.1007/s00134-003-1727-x

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