Hepatitis

Biography

Biography: Dr. Tari Magdy George Michael

Abstract

Thrombocytopenia is one of the common features of advanced liver cirrhosis. Liver transplantation is the only treatment for end stage liver disease, but even after transplantation thrombocytopenia is frequent. The aim of this study was to monitor platlets count and to identify factors contributing to persistence of thrombocytopenia following liver transplantation. The study included 36 patients who underwent LDLT in Ain Shams Center of Organ Transplantation (ASCOT) in one year (2013). Preoperative platelet count was recorded. Following transplantation, platelets count was recorded daily for the first two weeks, then at one month, 3 months, 6 months and 12 months. Splenic size and portal venous blood flow was measured at the same intervals by Doppler ultrasound. Thrombopoietin was measured before surgery then at 2 weeks and 6 months following transplantation. Persistent thrombocytopenia was defined as a platelet count less than 150 x 109/L at one year post-transplantation. At the end of the study, 56% of patients had persistent thrombocytopenia at 1 year. Factors that showed significant correlation with persistent thrombocytopenia were lower preoperative platelet count, lower preoperative portal vein flow velocity, greater preoperative spleen size, higher GRWR and longer operative time. Highest sensitivity was found for preoperative portal flow velocity and highest specificity was to GRWR. HCV recurrence, rejection episodes, CMV infection, biliary and vascular complications post operative were not independent factors for persistent thrombocytopenia.