Safety and Threshold Analysis of Preoperative Platelets in Right Lobe Living Donors for Liver Transplantation

Background Low perioperative platelet count is a powerful independent risk factor for posthepatectomy liver failure. Usually, categorical effect of thrombocytopenia was taken into account; upper thresholds were not studied in depth, exclusively in living liver donors. Methods Living liver donors who...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2022, Vol.26 (1), p.77-85
Main Authors: Kisaoglu, Abdullah, Doğru, Volkan, Yilmaz, Vural Taner, Demiryilmaz, Ismail, Avanaz, Ali, Sarikaya, Seyyit Muhsin, Dinc, Bora, Aydinli, Bulent
Format: Article
Language:English
Subjects:
Bile ducts
Blood & organ donations
Blood Platelets
Body mass index
Gastroenterology
Growth factors
Hepatectomy
Hepatectomy - adverse effects
Humans
Liver - surgery
Liver Failure - etiology
Liver Transplantation - adverse effects
Liver transplants
Living Donors
Medicine
Medicine & Public Health
Original Article
Surgery
Thrombocytopenia
Veins & arteries
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Summary:Background Low perioperative platelet count is a powerful independent risk factor for posthepatectomy liver failure. Usually, categorical effect of thrombocytopenia was taken into account; upper thresholds were not studied in depth, exclusively in living liver donors. Methods Living liver donors who underwent right hepatectomy were included. Preoperative characteristics of donors were identified and examined to predict posthepatectomy liver failure. To eliminate selection bias, one-to-one propensity score matching was performed. Results There were a total of 139 living donors and 40 (29%) donors developed posthepatectomy liver failure in the aftermath of the operation. Remnant liver volume ratio and preoperative platelet count were identified as adjustable independent risk factors (OR: 0.89 and 0.99, 95% CI: 0.79–0.99 and 0.98–0.99, respectively). After propensity score matching, odds ratio of preoperative platelet count was 0.99 (95% CI: 0.98–1.00). Conclusions Preoperative platelet count, in addition to remnant liver volume ratio, can be used as a surrogate marker to predict the risk of posthepatectomy liver failure in living liver right lobe donors. Probability curves figured out from logistic regression analysis, in this regard, provided an explicit perspective of platelets having a decisive role on liver donor safety. Thus, remaining in safer remnant liver volume ratio limits with respect to preoperative platelet count should be addressed in safe donor selection strategies.
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-021-05047-5