Thrombocytopenia after liver transplantation: Should we care?

Table 1 Reports of postoperative thrombocytopenia after liver transplant

Author	Year	Type	Number of patients	Results
Hutchison et al[23]	1968	DDLT	8	Platelet count change from 200-400 × 103/μL to 67 × 103/μL on POD 3
Plevak et al[16]	1988	DDLT	76	Platelet count change from 137 × 103/μL to 72 × 103/μL on POD 3
Munoz et al[15]	1989	DDLT	3	Three patients with severe postoperative thrombocytopenia were successfully treated with high-dose gamma-globulin
McCaughan et al[17]	1992	DDLT	53	Patients who died during their hospital stay had lower postoperative platelet counts at the nadir, and the day of the nadir tended to be delayed
Chatzipetrou et al[24]	1999	DDLT	541	A platelet nadir of < 20 × 103/μL was associated with allograft dysfunction, graft rejection and poorer patient and graft survival
Chang et al[25]	2000	DDLT	50	Fungal infection was frequent in patients with a platelet nadir of < 30 × 103/μL
Ben Hamida et al[26]	2003	DDLT	161	Patients with a platelet count < 50 × 103/μL for three consecutive days showed a high mortality rate.
Nascimbene et al[19]	2007	DDLT	8	Infusion of high-dose gamma-globulins induced a prompt, complete and persistent resolution of postoperative severe thrombocytopenia in more than 70% of patients
Kim et al[47]	2010	LDLT	87	A total unit of platelet transfusion was significantly associated with graft regeneration
Lesurtel et al[28]	2014	DDLT	247	A platelet count of < 60 × 103/μL on POD 5 was related to poor graft survival within 90 d after LT
Sonny et al[27]	2015	DDLT	223	A preoperative platelet count of < 45 × 103/μL was related with short-term outcomes in patients ≥ 60 years old
Li et al[49]	2015	LDLT	234	Patients with an immediate postoperative platelet count of < 68 × 103/μL had a higher chance of developing EAD and severe complications
Takahashi et al[29]	2016	DDLT	975	A platelet count of < 72.5 × 103/μL on POD 5 was related to poor graft survival
Han et al[48]	2016	LDLT	441	An intraoperative platelet transfusion was also independently associated with enhanced graft regeneration at 14 ± 2 d after surgery
Pamecha et al[50]	2016	LDLT	120	A platelet count of < 30 × 103/μL on POD 3 was a strong predictor of complications and EAD
Gwiasda et al[31]	2017	DDLT	134	A higher preoperative platelet count was related to graft loss
Takahashi et al[30]	2017	DDLT	771	Persistent thrombocytopenia within 5 d after LT was related to progression of biliary anastomotic stricture
Akamatsu et al[51]	2017	LDLT	445	A Low platelet count on POD 3 was an independent predictor of grade IIIb/IV complications

LT: Liver transplant; DDLT: Deceased donor liver transplant; LDLT: Living donor liver transplant; POD: Postoperative day; EAD: Early allograft dysfunction.