• Hai-Qing Wang, Jian Yang, Jia-Yin Yang, Wen-Tao Wang, and Lu-Nan Yan.
• Hai-Qing Wang, Jian Yang, Jia-Yin Yang, Wen-Tao Wang, Lu-Nan Yan, Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.
• World J. Gastroenterol. 2014 Sep 7; 20 (33): 11871-7.

AimTo investigate the relationship between low immediate postoperative platelet count and perioperative outcome after liver resection in patients with hepatocellular carcinoma (HCC).MethodsIn a cohort of 565 consecutive hepatitis B-related HCC patients who underwent major liver resection, the characteristics and clinical outcomes after liver resection were compared between patients with immediate postoperative platelet count < 100 × 10(9)/L and patients with platelet count ≥ 100 × 10(9)/L. Risk factors for postoperative hepatic insufficiency were evaluated by multivariate analysis.ResultsPatients with a low immediate postoperative platelet count (< 100 × 10(9)/L) had more grade III-V complications (20.5% vs 12.4%, P = 0.016), and higher rates of postoperative liver failure (6.8% vs 2.6%, P = 0.02), hepatic insufficiency (31.5% vs 21.2%, P < 0.001) and mortality (6.8% vs 0.5%, P < 0.001), compared to patients with a platelet count ≥ 100 × 10(9)/L. The alanine aminotransferase levels on postoperative days 3 and 5, and bilirubin on postoperative days 1, 3 and 5 were higher in patients with immediate postoperative low platelet count. Multivariate analysis revealed that immediate postoperative low platelet count, rather than preoperative low platelet count, was a significant independent risk factor for hepatic insufficiency.ConclusionA low immediate postoperative platelet count is an independent risk factor for hepatic insufficiency. Platelets can mediate liver regeneration in the cirrhotic liver.

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