Thrombopenia after liver transplantation

Thrombocytopenia (TP) is a common finding after liver transplantation and is often multifactorially induced. In 31 of 33 liver transplant recipients (operated between 1986 and 1991 at our institution) TP was observed but only in 4 the nadir of the platelet count was less than 20 000/mm3. Highly significant influence in the severity of postoperative TP as well as on the recovery time (defined as the first day with a platelet count higher than 100 000/mm3) was found for a preexisting TP and for the intraoperative need for blood transfusions. 8/33 patients had a concomitant splenectomy but no effect on platelet nadir nor on the recovery time could be detected. In our series we could not find any platelet related factor with a significant impact on patient survival. In one patient severe TP was induced by a CMV-related hematophagic histocytosis fully regredient with antiviral therapy. Another patient with ABO incompatible graft had a severe TP induced by graft versus host disease.