Low immediate postoperative platelet count is associated with hepatic insufficiency after hepatectomy

Abstract

A low immediate postoperative platelet count is an independent risk factor for hepatic insufficiency. Platelets can mediate liver regeneration in the cirrhotic liver.

Meta-analysis of the prognostic role of perioperative platelet count in posthepatectomy liver failure and mortality

“…Tomimaru and colleagues did not report the timing of platelet measurement. Eight studies included only patients who underwent hepatectomy for primary liver malignancy. Alkozai and colleagues, Reidiger et al .…”

“…. In the 100/nl cut‐off group, four studies included 949 patients in analysis of PHLF. PHLF occurred in 20·5 per cent of patients with a PLT less than 100/nl compared with 12·9 per cent of patients with a PLT of 100/nl or more.…”

“…. A total of 3487 patients from seven studies were included in the meta‐analysis of the 100/nl PLT cut‐off. Deaths in the two groups were not reported separately by Alkozai and colleagues, so deaths were calculated in each group based on the number of patients and the OR.…”

Impact of early postoperative platelet count on volumetric liver gain and perioperative outcomes after major liver resection

“…Although current experimental evidence supports a stimulatory role for platelets in liver regeneration in animals, conclusive evidence for the exact mechanisms underlying such an effect in humans is still lacking. To date, the impact of platelet count on liver regeneration in humans has been assessed only indirectly using outcome parameters such as 90‐day postoperative morbidity and mortality, as well liver dysfunction measured by increased serum levels of liver enzymes.…”

Evidence against a role for platelet-derived molecules in liver regeneration after partial hepatectomy in humans

“…In addition, platelets have roles beyond physiological or pathological thrombus formation [1][2][3]. Animal models and clinical studies have suggested a pivotal role for platelets in stimulation of liver regeneration [4][5][6][7][8][9][10]. Although there is broad consensus that platelets stimulate liver regenera- tion in animal models and likely also in humans, there is ongoing debate on the molecular mechanisms underlying platelet-mediated stimulation of liver regeneration [11,12].…”