Low viscoelastic clot strength, platelet transfusions, and graft dysfunction are associated with persistent postoperative ascites following liver transplantation - 08/12/22
, Tanner Ferrell b, Angela Sauaia b, c, Ivan E. Rodriguez b, d, Dor Yoeli b, d, Trevor L. Nydam b, d, Peter T. Kennealey b, d, James J. Pomposelli b, d, Elizabeth A. Pomfret b, d, Hunter B. Moore b, d, ⁎ Abstract |
Introduction |
High output, persistent ascites (PA) is a common complication following liver transplant (LT). Recent work has identified that platelets help maintain endothelial integrity and can decrease leakage in pathological states. We sought to assess the association of PA following LT with platelet count and platelet function.
Methods |
Clot strength (MA) is a measure of platelet function and was quantified using thrombelastography (TEG). Total drain output following surgery was recorded in 24-h intervals during the same time frame as TEG. PA was considered >1 L on POD7, as that much output prohibits drain removal.
Results |
105 LT recipients with moderate or high volume preoperative ascites were prospectively enrolled. PA occurred in 28%. Platelet transfusions before and after surgery were associated with PA, in addition to POD5 TEG MA and POD5 MELD score. Patients with PA had a longer hospital length of stay and an increased rate of intraabdominal infections.
Conclusion |
Persistent ascites following liver transplant is relatively common and associated with platelet transfusions, low clot strength, and graft dysfunction.
Le texte complet de cet article est disponible en PDF.Highlights |
• | High output persistent ascites (PA) occurs in 28% of liver transplant recipients. |
• | Platelet transfusions given preoperatively were a significant and independent predictor of persistent high output ascites. |
• | An increase in POD5 MELD and TEG MA postoperatively were significant predictors of PA. |
• | Post-operative PA was associated with longer hospital stays, higher rates of intraabdominal infection, and graft dysfunction. |
Keywords : Persistent ascites, Liver transplantation, Platelets, Postoperative complications, Thrombelastography
Plan
| ☆ | This study was supported in part by National Heart Lung and Blood Institute: R00-HL151887 and American Society of Transplant Surgeons Veloxis Fellowship Award, and University of Colorado Academic Enrichment Fund |
Vol 224 - N° 6
P. 1432-1437 - décembre 2022 Retour au numéro
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