gms | German Medical Science

130. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

30.04. - 03.05.2013, München

Platelet sequestration correlates with cold ischemia time and hepatocellular injury after liver transplantation

Meeting Abstract

  • Andrej Khandoga - Klinikum der Universität München, Chirurgische Klinik Großhadern, München
  • Emil Iskandarov - Klinikum der Universität München, Chirurgische Klinik Großhadern, München
  • Konstantin Mende - Klinikum der Universität München, Chirurgische Klinik Großhadern, München
  • Karl-Walter Jauch - Klinikum der Universität München, Chirurgische Klinik Großhadern, München
  • Markus Rentsch - Klinikum der Universität München, Chirurgische Klinik Großhadern, München
  • Markus Guba - Klinikum der Universität München, Chirurgische Klinik Großhadern, München

Deutsche Gesellschaft für Chirurgie. 130. Kongress der Deutschen Gesellschaft für Chirurgie. München, 30.04.-03.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13dgch850

doi: 10.3205/13dgch850, urn:nbn:de:0183-13dgch8506

Veröffentlicht: 26. April 2013

© 2013 Khandoga et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Experimental studies provide evidence that i) platelets accumulate in the postischemic liver and play a critical role for ischemia-reperfusion (I/R) injury, ii) interventions against platelet recruitment reduce hepatocellular damage and improve postoperative survival in various models of liver ischemia and transplantation. In this study, we answered the question whether platelet loss after liver transplantation depends on cold ischemia time and correlates with hepatocellular injury in liver transplant patients.

Material and methods: We analyzed retrospective data of patients undergoing cadaveric donor liver transplantation in 2011 in our transplantation center. Patients were divided in three groups according to cold ischemia time: A) 5-8h (n=7), B) 9-10h (n=19), C) 11-13h (n=9). We compared platelet counts and liver enzyme activities before transplantation and during the first three postoperative days. The analysis of platelet counts considered perioperative substitution of platelet concentrates.

Results: After liver transplantation, the total number of circulating platelets was reduced in group A at 40±13% on the 1st day, at 39±14% on the 2nd day and at 51±17% on the 3rd day as compared to the preoperative values. Platelet loss was higher in group B (51±7%, 74±6%, 78±8%, respectively) and reached the highest values in group C (58±7%, 84±19%, 83±15%, respectively). The liver enzyme activities correlated with the extent of platelet sequestration (Table 1 [Tab. 1]).

Conclusion: Our clinical data show that platelet sequestration after liver transplantation correlates with the duration of cold ischemia and hepatocellular injury. These results support the experimental data and discuss platelets as a potential target for future interventions against I/R injury during liver transplantation.