Early post‐liver transplant thrombocytopenia in children: Clinical characteristics and significance. (22nd May 2022)

• Record Type: Journal Article
• Authors: Tal, Noa; Waisbourd‐Zinman, Orith; Kaplan, Eytan; Kadmon, Gili; Gendler, Yulia; Gurevich, Michael; Nahum, Elhanan; Weissbach, Avichai
• Is Part Of: Pediatric transplantation. Volume 26:Number 6(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-05-22
• Subjects: blood transfusion -- hypersplenism -- liver transplantation -- pediatric intensive care unit -- thrombocytopenia; Transplantation of organs, tissues, etc. in children -- Periodicals; 617.95408305
• DOI: 10.1111/petr.14326
• Languages: English
• ISSNs: 1397-3142

Abstract

Abstract: Background: Post‐liver transplant thrombocytopenia is common and associated with worse outcome in adults. In children, however, the prevalence, course, and significance of post‐liver transplantation thrombocytopenia are not described. Therefore, we aimed to assess this phenomenon in children. Methods: A retrospective chart review of children who underwent liver transplantation at a single tertiary center between 2004 and 2021. Results: Overall, 130 pediatric liver transplantations were reviewed. During the first 28 POD, thrombocytopenia was evident in 116 (89%, 95% CI 83%–94%). The median nadir platelet count was 54 K/μl (IQR: 37–99). Nadir platelet count was reached in half the patients by the third POD (IQR: 1–6). In multivariate analysis, preoperative platelet count ( p = .024), volume of intraoperative packed cell transfusion ( p = .045), and hypersplenism ( p = .007) were associated with lower postoperative platelet counts. Patients with platelet count lower than the 50th centile on the first POD suffered from a more complicated course leading to a longer PICU admission ( p = .039). Conclusions: Early post‐liver transplant thrombocytopenia appears to be common in children and associated with preoperative thrombocytopenia, hypersplenism, and higher intraoperative blood transfusion volumes. A low first POD platelet count (<86 K/μl) was found to be independently associated with a more complicated postoperative course, suggesting the need for heightened surveillance.