Low Postoperative Platelet Count is Associated with Higher Morbidity after Liver Surgery for Colorectal Metastase

Riediger, Carina

doi:10.4172/2167-0889.1000166

Cited by 4 publications

(10 citation statements)

References 34 publications

(46 reference statements)

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“…However, these patients often suffer from liver cirrhosis, which may constitute an important confounding factor by impairing platelet counts and leading to portal hypertension. Studies in patients who received surgery for colorectal cancer metastases with otherwise healthy liver tissue and in liver transplantation showed similar results. Further, platelet count and platelet transfusion were described to correlate with postoperative liver volume increases, measured by computed tomography, after both partial hepatectomy and living donor transplantation , respectively.…”

Section: Platelet Counts Correlate With Posthepatectomy Liver Functiomentioning

confidence: 61%

Platelets in liver regeneration

Meyer

Balaphas

Fontana

et al. 2017

ISBT Science Series

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Background and Objectives Loss of liver tissue leading to impairment of liver function represents a major cause of mortality. Understanding the mechanism of liver regeneration and developing therapies to sustain liver regeneration are of high therapeutic relevance. In this regard, platelets are considered as potential candidates for stimulating liver regeneration.Methods We aim to review the most recent evidence regarding the role of platelets in liver regeneration.Results Platelets stimulate liver regeneration in animal models of liver resection. In humans, platelets are independent predictors of postoperative mortality, liver function and volume recovery. One proposed mechanism by which platelets stimulate liver regeneration relies on their direct effect on hepatocytes. Following partial hepatectomy, platelets accumulate in the residual liver and release their granule content. Platelet-containing molecules, such as HGF, VEGF, IGF-1 and serotonin, stimulate hepatocyte proliferation. A putative additional mechanism involves the transfer of platelet mRNA to hepatocytes following platelet internalization. Recent studies have suggested that the effect of platelets relies on their interactions with LSEC. Platelets induce the secretion of IL-6 from LSEC, a strong initiator of hepatocyte proliferation. Additionally, platelets convey molecules that may impact LSEC function and, by extension, liver regeneration. Platelets potentially interact with Kupffer cells, but the effect of that interaction on liver regeneration remains to be determined.Conclusion Platelets stimulate liver regeneration. Several mechanisms seem to be involved, acting on the level of hepatocytes, LSEC and potentially Kupffer cells. Identification of the platelet-molecule(s) involved may lead to targeted therapies for patients with impairment of liver function.

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Section: Platelet Counts Correlate With Posthepatectomy Liver Functiomentioning

confidence: 61%

Platelets in liver regeneration

Meyer

Balaphas

Fontana

et al. 2017

ISBT Science Series

View full text Add to dashboard Cite

show abstract

“…. 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.…”

Section: Resultsmentioning

confidence: 99%

“…A further 611 articles were excluded for various reasons, such as irrelevant studies, experimental studies or review articles. After reading the remaining 103 articles, 16 studies were included in the qualitative analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies included only patients who underwent hepatectomy for primary liver malignancy. Alkozai and colleagues, Reidiger et al . and Ratti and co‐workers reported only patients with liver metastasis, whereas all primary, metastatic and benign tumours were indications for hepatectomy in five studies .…”

Section: Resultsmentioning

confidence: 99%

“…Predicting risk factors for PHLF plays a vital role in planning a patient's perioperative course and decreasing liver‐related mortality after hepatectomy. A review of the literature showed that PHLF rates range from 0 to 43·1 per cent, and mortality rates between 0·5 and 15·6 per cent. This variation can be explained by use of different definitions of PHLF, different time points for mortality, and variability in the degree of hepatectomy, which led to clinical heterogeneity between included studies.…”

Section: Discussionmentioning

confidence: 99%

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