Evolution of platelet functions in cirrhotic patients undergoing liver transplantation: A prospective exploration over a month

PLoS One. 2018 Aug 2;13(8):e0200364. doi: 10.1371/journal.pone.0200364. eCollection 2018.

Abstract

This prospective observational study was designed to analyze platelet functions across time in 50 patients scheduled for liver transplantation (LT) secondary to decompensated cirrhosis or hepatocellular carcinoma. Platelet functions were assessed before LT (pre-LT), one week (D7) and 1 month (D28) after LT. Platelet count significantly increased from pre-LT time to day 28 as well as circulating CD34+hematopoietic stem cells. To avoid any influence of platelet count on assays, platelet function was evaluated on platelet-rich-plasma adjusted to pre-LT platelet count. Although platelet secretion potential did not differ between time-points, as evaluated by the expression of CD62P upon strong activation, platelet aggregation in response to various agonists significantly increased along time, however with no concomitant increase of circulating markers of platelet activation: platelet microvesicles, platelet-leukocyte complexes, soluble CD40L and soluble CD62P. In the multivariate analysis, hepatic function was associated with platelet count and function. A lower platelet aggregation recovery was correlated with Child C score. History of thrombosis or bleeding was associated with respective higher or lower values of platelet aggregation. This longitudinal analysis of platelet functions in LT patients showed an improvement of platelet functions along time together with platelet count increase, with no evidence of platelet hyperactivation at any time-point.

MeSH terms

  • Blood Platelets / cytology*
  • Blood Platelets / metabolism
  • CD40 Ligand / metabolism
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy
  • Female
  • Hemorrhage / pathology
  • Humans
  • Liver / enzymology
  • Liver / metabolism
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / therapy*
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy
  • Liver Transplantation*
  • Male
  • Middle Aged
  • P-Selectin / metabolism
  • Platelet Activation
  • Platelet Aggregation
  • Platelet Count
  • Platelet Function Tests
  • Prospective Studies
  • Thrombosis / pathology

Substances

  • P-Selectin
  • CD40 Ligand

Grant support

The authors received no specific funding for this work.