Highlights
- •High output persistent ascites (PA) occurs in 28% of liver transplant recipients.
- •Platelet transfusions given preoperatively were a significant and independent predictor of persistent high output ascites.
- •An increase in POD5 MELD and TEG MA postoperatively were significant predictors of PA.
- •Post-operative PA was associated with longer hospital stays, higher rates of intraabdominal infection, and graft dysfunction.
Abstract
Introduction
High output, persistent ascites (PA) is a common complication following liver transplant
(LT). Recent work has identified that platelets help maintain endothelial integrity
and can decrease leakage in pathological states. We sought to assess the association
of PA following LT with platelet count and platelet function.
Methods
Clot strength (MA) is a measure of platelet function and was quantified using thrombelastography
(TEG). Total drain output following surgery was recorded in 24-h intervals during
the same time frame as TEG. PA was considered >1 L on POD7, as that much output prohibits
drain removal.
Results
105 LT recipients with moderate or high volume preoperative ascites were prospectively
enrolled. PA occurred in 28%. Platelet transfusions before and after surgery were
associated with PA, in addition to POD5 TEG MA and POD5 MELD score. Patients with
PA had a longer hospital length of stay and an increased rate of intraabdominal infections.
Conclusion
Persistent ascites following liver transplant is relatively common and associated
with platelet transfusions, low clot strength, and graft dysfunction.
Keywords
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Article info
Publication history
Published online: October 01, 2022
Accepted:
September 28,
2022
Received in revised form:
August 25,
2022
Received:
March 25,
2022
Footnotes
☆This study was supported in part by National Heart Lung and Blood Institute: R00-HL151887 and American Society of Transplant Surgeons Veloxis Fellowship Award, and University of Colorado Academic Enrichment Fund
Identification
Copyright
© 2022 Published by Elsevier Inc.
