Preoperative platelet count predicts posttransplant portal vein complications in orthotopic liver transplantation: a propensity score analysis

Background: The role of platelets on the prognosis of patients with liver transplantation remains unclear. Thus, we aimed to evaluate the influence of preoperative platelet count on postoperative morbidity after liver transplantation. Methods: Clinical data of the patients who received liver transplantation from January 2015 to September 2018 were evaluated. Results: Of the 329 patients included, the average age was 46.71±0.55 years, and 243 were men (75.2%). The incidence of posttransplant portal vein complication was significantly higher in the high platelet count group (> 49.5×109/L; n=167) than in the low platelet count group (≤ 49.5×109/L, n=162, 12.6% vs. 1.9%). After multivariable regression analysis, high platelet count was independently associated with postoperative portal vein complication (odds ratio [OR]: 8.821, 95% confidence interval [CI]: 2.260 to 34.437). After the inverse probability of treatment weighting analysis, patients in the high platelet count group had significantly higher risk of portal vein complication (OR: 9.210, 95%CI: 1.907 to 44.498, p=0.006) and early allograft dysfunction (OR: 2.087, 95%CI: 1.131 to 3.853, p=0.019). Conclusions: Preoperative platelet count > 49.5×109/L was an independent risk factor for posttransplant portal vein complication and early allograft dysfunction. High preoperative platelet count could be an adverse prognostic predictor for liver transplantation recipients.