Can preoperative thrombocytopenia be a risk indicator for emergency surgery due to liver transplant complications?

Vollständiger Abstract

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Aim: This study aimed to investigate the effect of preoperative thrombocytopenia and other risk factors on the need for emergency surgery due to complications following living donor liver transplantation (LDLT), and to evaluate the impact of emergency surgery on patient survival.Materials and Methods: The data of 270 patients who underwent LDLT for end-stage liver disease between July 2021 and October 2023 were analyzed retrospectively. Patients were divided into two groups: those requiring postoperative emergency surgery and those who did not. Preoperative demographic findings, etiology, comorbidities, Model for End-Stage Liver Disease (MELD) scores, and laboratory parameters (including platelet counts and INR) were compared between the groups.Results: Postoperative emergency surgery was required in 31 (11%) patients. The most common indications were portal vein thrombosis, intra-abdominal bleeding, and hepatic vein thrombosis. The mean preoperative platelet count was significantly lower (p=0.027) and INR was significantly higher (p=0.047) in the emergency surgery group compared to the non-emergency group. A platelet cut-off value of 81,000/mm³ was identified for predicting reoperation. There was no statistically significant difference between the groups regarding comorbidities or decompensation findings. Emergency surgical intervention significantly shortened patient survival (p