Skip to main content
SpringerLink
Log in

Platelet Transfusion can be Related to Liver Regeneration After Living Donor Liver Transplantation

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Although liver regeneration is a fundamental aspect of living donor liver transplantation (LDLT), the factors that affect liver regeneration during the early post-transplantation period have not been thoroughly investigated. Recently it was suggested that platelets contribute to liver regeneration. The aim of the present study was to identify the major factors that affect liver graft regeneration during the early post-transplantation period.

Materials and methods

Eighty-seven right liver grafted, adult-to-adult LDLT patients were retrospectively analyzed. Liver regeneration was assessed by volumetry from computed tomographic (CT) scans obtained between the 9th and 11th postoperative days. The authors investigated relationships between clinical variables and liver graft regeneration rates, and they conducted multiple regression analysis on factors found to be significant by univariate analysis.

Results

Mean graft weight at operation was 722.9 ± 109.7 g, and mean graft volume assessed by follow-up CT was 1,042.2 ± 155.6 ml, reflecting a mean liver graft regeneration of 45.9 ± 22.3%. The graft regeneration was found to correlate inversely with graft-to-recipient weight ratio (GRWR, r = −0.406, p < 0.001) and directly with portal flow velocity (cm/s; r = 0.307; p = 0.004) and splenic index (cm3; r = 0.282; p = 0.009). Moreover, the total amount (units) of platelets transfused was found to be significantly associated with graft regeneration (r = 0.293; p = −.006). Stepwise regression analysis showed that GRWR (β = −33.124; p = 0.001), total amount of platelets transfused (β = 0.771; p = 0.012), and splenic index (β = −0.010; p = 0.049) were independently associated with graft regeneration.

Conclusions

The results of the present study suggest that platelets play a significant role in human liver regeneration after LDLT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Clavien P, Petrowsky H, DeOliveira M et al (2007) Strategies for safer liver surgery and partial liver transplantation. N Engl J Med 356:1545–1559

    Article  PubMed  Google Scholar 

  2. Muraoka N, Uematsu H, Kimura H et al (2008) Rate of liver volume increase: can it predict recipient prognosis after left lobe transplantation from living related donors? Clin Imaging 32:6–10

    Article  PubMed  Google Scholar 

  3. Clavien P (2008) Liver regeneration: a spotlight on the novel role of platelets and serotonin. Swiss Med Wkly 138:361–370

    CAS  PubMed  Google Scholar 

  4. Michalopoulos G, DeFrances M (1997) Liver regeneration. Science 276:60–66

    Article  CAS  PubMed  Google Scholar 

  5. Tan X, Behari J, Cieply B et al (2006) Conditional deletion of beta-catenin reveals its role in liver growth and regeneration. Gastroenterology 131:1561–1572

    Article  CAS  PubMed  Google Scholar 

  6. Taub R (2004) Liver regeneration: from myth to mechanism. Nat Rev Mol Cell Biol 5:836–847

    Article  CAS  PubMed  Google Scholar 

  7. Yagi S, Iida T, Taniguchi K et al (2005) Impact of portal venous pressure on regeneration and graft damage after living-donor liver transpl. Liver Transplant 11:68–75

    Article  PubMed  Google Scholar 

  8. Eguchi S, Yanaga K, Sugiyama N et al (2003) Relationship between portal venous flow and liver regeneration in patients after living donor right-lobe liver transplantation. Liver Transpl 9:547–551

    Article  PubMed  Google Scholar 

  9. Maetani Y, Itoh K, Egawa H et al (2003) Factors influencing liver regeneration following living-donor liver transplantation of the right hepatic lobe. Transplantation 75:97–102

    Article  PubMed  Google Scholar 

  10. Lesurtel M, Graf R, Aleil B et al (2006) Platelet-derived serotonin mediates liver regeneration. Science 312:104–107

    Article  CAS  PubMed  Google Scholar 

  11. Nocito A, Georgiev P, Dahm F et al (2007) Platelets and platelet-derived serotonin promote tissue repair after normothermic hepatic ischemia in mice. Hepatology 45:369–376

    Article  CAS  PubMed  Google Scholar 

  12. Murata S, Ohkohchi N, Matsuo R et al (2007) Platelets promote liver regeneration in early period after hepatectomy in mice. World J Surg 31:808–816

    Article  PubMed  Google Scholar 

  13. Yu HC, You H, Lee H et al (2004) Estimation of standard liver volume for liver transplantation in the Korean population. Liver Transpl 10:779–783

    Article  PubMed  Google Scholar 

  14. Heinemann A, Wischhusen F, Puschel K et al (1999) Standard liver volume in the Caucasian population. Liver Transpl Surg 5:366–368

    Article  CAS  PubMed  Google Scholar 

  15. Marcos A, Fisher R, Ham J et al (2000) Liver regeneration and function in donor and recipient after right lobe adult to adult living donor liver transplantation. Transplantation 69:1375–1379

    Article  CAS  PubMed  Google Scholar 

  16. Uslu Tutar N, Kirbaş I, Oztürk A et al (2007) Computed tomography volumetric follow-up of graft volume in living related liver recipients. Transplant Proc 39:1175–1177

    Article  CAS  PubMed  Google Scholar 

  17. Dahm F, Georgiev P, Clavien P (2005) Small-for-size syndrome after partial liver transplantation: definition, mechanisms of disease and clinical implications. Am J Transplant 5:2605–2610

    Article  PubMed  Google Scholar 

  18. Umeda Y, Yagi T, Sadamori H et al (2008) Effects of prophylactic splenic artery modulation on portal overperfusion and liver regeneration in small-for-size graft. Transplantation 86:673–680

    Article  PubMed  Google Scholar 

  19. Ando H, Nagino M, Arai T et al (2004) Changes in splenic volume during liver regeneration. World J Surg 28:977–981

    Article  PubMed  Google Scholar 

  20. Ibrahim S, Chen C, Wang C et al (2005) Liver regeneration and splenic enlargement in donors after living-donor liver transplantation. World J Surg 29:1658–1666

    Article  PubMed  Google Scholar 

  21. Eipel C, Glanemann M, Nuessler A et al (2005) Ischemic preconditioning impairs liver regeneration in extended reduced-size livers. Ann Surg 241:477

    Article  PubMed  Google Scholar 

  22. Kelly D, Demetris A, Fung J et al (2004) Porcine partial liver transplantation: a novel model of the “small-for-size” liver graft. Liver Transpl 10:253–263

    Article  PubMed  Google Scholar 

  23. Troisi R, de Hemptinne B (2003) Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients. Liver Transpl 9:S36–S41

    Article  PubMed  Google Scholar 

  24. Marubashi S, Dono K, Miyamoto A et al (2007) Impact of graft size on postoperative thrombocytopenia in living donor liver transplant. Arch Surg 142:1054

    Article  PubMed  Google Scholar 

  25. Troisi R, Ricciardi S, Smeets P et al (2005) Effects of hemi-portocaval shunts for inflow modulation on the outcome of small-for-size grafts in living donor liver transplantation. Am J Transplant 5:1397–1404

    Article  PubMed  Google Scholar 

  26. Saner F, Sotiropoulous GC, Radtke A et al (2005) Small-for-size syndrome after living-donor liver transplantation treated by “portal vein wrapping” and single plasmapheresis. Transplantation 79:625

    Article  PubMed  Google Scholar 

  27. Ueda S, Yamanoi A, Hishikawa Y et al (2003) Transforming growth factor-bold beta 1 released from the spleen exerts a growth inhibitory effect on liver regeneration in rats. Lab Invest 83:1595–1603

    Article  CAS  PubMed  Google Scholar 

  28. Pereboom I, Lisman T, Porte R (2008) Platelets in liver transplantation: friend or foe? Liver Transpl 14:923–931

    Article  PubMed  Google Scholar 

  29. Murata S, Hashimoto I, Nakano Y et al (2008) Single administration of thrombopoietin prevents progression of liver fibrosis and promotes liver regeneration after partial hepatectomy in cirrhotic rats. Ann Surg 248:821–828

    Article  PubMed  Google Scholar 

  30. Cywes R, Packham M, Tietze L et al (1993) Role of platelets in hepatic allograft preservation injury in the rat. Hepatology 18:635–647

    Article  CAS  PubMed  Google Scholar 

  31. De Boer M, Christensen M, Asmussen M et al (2008) The impact of intraoperative transfusion of platelets and red blood cells on survival after liver transplantation. Anesth Analg 106:32

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We appreciate the statistical assistance provided by the Medical Research Collaborating Center at Seoul National University College of Medicine/Seoul National University Hospital.

Author information

Authors and Affiliations

  1. Department of Surgery, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 1 Hoegi-Dong, Dongdaemun-Gu, Seoul, 130-702, Republic of Korea

    Joohyun Kim

  2. Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, Republic of Korea

    Nam-Joon Yi, Woo Young Shin, Taehoon Kim, Kuhn Uk Lee & Kyung-Suk Suh

Authors
  1. Joohyun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nam-Joon Yi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Woo Young Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Taehoon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kuhn Uk Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kyung-Suk Suh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kyung-Suk Suh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, J., Yi, NJ., Shin, W.Y. et al. Platelet Transfusion can be Related to Liver Regeneration After Living Donor Liver Transplantation. World J Surg 34, 1052–1058 (2010). https://doi.org/10.1007/s00268-010-0464-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-010-0464-x

Keywords

Search

Navigation