This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Pereboom, I. T. A. Articles by Porte, R. J. Search for Related Content PubMed Articles by Pereboom, I. T. A. Articles by Porte, R. J. Related Collections Cardiovascular Critical Care Blood Coagulation Outcomes

---

CARDIOVASCULAR ANESTHESIOLOGY

Platelet Transfusion During Liver Transplantation Is Associated with Increased Postoperative Mortality Due to Acute Lung Injury

Ilona T. A. Pereboom^*, Marieke T. de Boer^*, Elizabeth B. Haagsma, Herman G. D. Hendriks, Ton Lisman^*, and Robert J. Porte^*

From the Departments of *Surgery, Section Hepatobiliary Surgery and Liver Transplantation, Gastroenterology and Hepatology, and Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Address correspondence and reprint requests to Robert J. Porte, MD, PhD, Department of Surgery, Section Hepatobiliary Surgery and Liver Transplantation, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Address e-mail to r.j.porte{at}chir.umcg.nl.

Abstract

BACKGROUND: Platelet transfusions have been identified as an independent risk factor for survival after orthotopic liver transplantation (OLT). In this study, we analyzed the specific causes of mortality and graft loss in relation to platelet transfusions during OLT.

METHODS: In a series of 449 consecutive adult patients undergoing a first OLT, the causes of patient death and graft failure were studied in patients who did or did not receive perioperative platelet transfusions.

RESULTS: Patient and graft survival were significantly reduced in patients who received platelet transfusions, compared with those who did not (74% vs 92%, and 69% vs 85%, respectively at 1 yr; P < 0.001). Lower survival rates in patients who received platelets were attributed to a significantly higher rate of early mortality because of acute lung injury (4.4% vs 0.4%; P = 0.004). There were no significant differences in other causes of mortality between the two groups. The main cause of graft loss in patients receiving platelets was patient death with a functioning graft.

CONCLUSIONS: These findings suggest that platelet transfusions are an important risk factor for mortality after OLT. The current study extends previous observations by identifying acute lung injury as the main determinant of increased mortality. The higher rate of graft loss in patients receiving platelets is related to the higher overall mortality rate and does not result from specific adverse effects of transfused platelets on the grafted liver.