关键词: 酒精性肝硬化, 肝移植术后, 血小板减少, 危险因素

Abstract: Objective To investigate whether pre-liver transplantation (LT) low low-density lipoprotein (LDL) level and pre-LT large spleen size were the risk factors for thrombocytopenia after LT. Methods A total of 81 patients who underwent LT for alcoholic cirrhosis in our hospital from April 2015 to November 2018 were enrolled. Patients with thrombocytopenia after LT were screened. Patients with platelet (PLT) level less than 100 × 10⁹/L and more than 100 × 109/L in 1 year after LT were selected into case group and control group, respectively. The influence of pre-LT LDL level and spleen size on post-LT PLT level was recorded. The averages of the 2 groups were compared by t test and non-parametric test. Logistic regression was used to analyze risk factors. Results Finally, 38 liver recipients met the inclusion criteria were enrolled. In the first year after LT, the PLT level of 9 patients decreased (case group), with the median of 86.0 (76.0, 89.0) ×10⁹/L, while 29 cases with normal PLT level (control group), with the median of 129.0 (118.0, 166.0) ×10⁹/L. Compared with control group, patients in case group had significant lower pre-LT PLT level (35±5.47×10⁹/L, 47(35, 61)×10⁹/L, respectively, Z=-2.04, P=0.041), lower pre-LT LDL level (0.86(0.82,1.29) mmol/L, 1.53(1.3, 2.34) mmol/L, Z=-2.68, P=0.006) and larger spleen size (6130±806.9 mm², 4410(3288, 5278.5) mm², Z=-2.05, P=0.041). Logistic regression analysis showed that lower pre-LT LDL level (OR=0.089, 95%CI: 0.012 - 0.675, P=0.019)) and large spleen size (OR=1.001, 95% CI: 1.000-1.001,P=0.024) were risk factors for thrombocytopenia after LT. Conclusion Low pre-LT LDL level and splenomegaly may induce thrombocytopenia after LT.

Key words: Alcoholic cirrhosis, Post liver transplantation, Thrombocytopenia, Risk factor