Can preoperative thrombocytopenia be a risk indicator for emergency surgery due to liver transplant complications?

Emrah Şahin; Ender Anılır; Abuzer Dirican; Bülent Ünal

doi:10.19161/etd.1855183

TR EN

Karaciğer nakli komplikasyonlarına bağlı acil cerrahide preoperatif trombositopeni bir risk göstergesi olabilir mi?

Abstract

Amaç: Bu çalışma, canlı vericili karaciğer nakli (LDLT) sonrası gelişen komplikasyonlara bağlı acil cerrahi gereksiniminde preoperatif trombositopeni ve diğer risk faktörlerinin etkisini araştırmayı ve acil cerrahinin hasta sağkalımı üzerindeki etkisini değerlendirmeyi amaçlamıştır. Gereç ve Yöntem: Temmuz 2021 ile Ekim 2023 tarihleri arasında son dönem karaciğer hastalığı nedeniyle LDLT uygulanan 270 hastanın verileri retrospektif olarak incelendi. Hastalar postoperatif acil cerrahi gerektirenler ve gerektirmeyenler olmak üzere iki gruba ayrıldı. Gruplar arasında preoperatif demografik bulgular, etyoloji, komorbiditeler, Son Dönem Karaciğer Hastalığı Modeli (MELD) skorları ve laboratuvar parametreleri (trombosit sayıları ve INR dahil) karşılaştırıldı. Bulgular: Postoperatif acil cerrahi 31 (%11) hastada gerekli görüldü. En sık endikasyonlar portal ven trombozu, karın içi kanama ve hepatik ven trombozu idi. Acil cerrahi grubunda preoperatif trombosit sayısı, cerrahi uygulanmayan gruba göre anlamlı derecede düşük (p=0,027) ve INR anlamlı derecede yüksek (p=0,047) saptandı. Yeniden ameliyatı öngörmede trombosit için kestirim değeri 81.000/mm³ olarak belirlendi. Komorbiditeler veya dekompansasyon bulguları açısından gruplar arasında istatistiksel olarak anlamlı fark izlenmedi. Acil cerrahi müdahalesi hasta sağkalımını anlamlı ölçüde kısalttı (p<0,001). Sonuç: LDLT alıcılarında preoperatif trombositopeni (özellikle 81.000/mm³ altındaki değerler) ve yüksek INR, acil cerrahi gerektiren postoperatif komplikasyonlar için önemli risk göstergeleridir. Acil cerrahi gereksinimi kötü sağkalım sonuçları ile ilişkilidir; bu nedenle yüksek riskli hastalar yakından izlenmelidir.

Keywords

Supporting Institution

Bu çalışma herhangi bir kamu, ticari veya kâr amacı gütmeyen kuruluş tarafından desteklenmemiştir.

Project Number

Bu çalışma herhangi bir kurum, kuruluş veya fon tarafından desteklenmemiştir.

Ethical Statement

Bu çalışma Helsinki Bildirgesi’ne uygun olarak yürütülmüştür. Çalışma için İstanbul Aydın Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu’ndan 15.11.2023 tarihli ve 2023/143 sayılı karar ile onay alınmıştır. Çalışmanın retrospektif tasarımı nedeniyle hasta onamı alınmamıştır.

Thanks

Teşekkür edilmesi gereken kişi veya kurum bulunmamaktadır.

Can preoperative thrombocytopenia be a risk indicator for emergency surgery due to liver transplant complications?

Abstract

Aim: This study aimed to investigate the effect of preoperative thrombocytopenia and other risk factors on the need for emergency surgery due to complications following living donor liver transplantation (LDLT), and to evaluate the impact of emergency surgery on patient survival. Materials and Methods: The data of 270 patients who underwent LDLT for end-stage liver disease between July 2021 and October 2023 were analyzed retrospectively. Patients were divided into two groups: those requiring postoperative emergency surgery and those who did not. Preoperative demographic findings, etiology, comorbidities, Model for End-Stage Liver Disease (MELD) scores, and laboratory parameters (including platelet counts and INR) were compared between the groups. Results: Postoperative emergency surgery was required in 31 (11%) patients. The most common indications were portal vein thrombosis, intra-abdominal bleeding, and hepatic vein thrombosis. The mean preoperative platelet count was significantly lower (p=0.027) and INR was significantly higher (p=0.047) in the emergency surgery group compared to the non-emergency group. A platelet cut-off value of 81,000/mm³ was identified for predicting reoperation. There was no statistically significant difference between the groups regarding comorbidities or decompensation findings. Emergency surgical intervention significantly shortened patient survival (p<0.001). Conclusions: Preoperative thrombocytopenia, particularly values below 81,000/mm³, and elevated INR are significant risk indicators for postoperative complications requiring emergency surgery in LDLT recipients. The need for emergency surgery is associated with poor survival outcomes; therefore, high-risk patients should be monitored closely.

Keywords

Supporting Institution

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Project Number

Bu çalışma herhangi bir kurum, kuruluş veya fon tarafından desteklenmemiştir.

Ethical Statement

This study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Istanbul Aydin University Non-Interventional Clinical Research Ethics Committee (Decision No: 2023/143, Date: November 15, 2023). Due to the retrospective nature of the study, informed consent was waived.

Thanks

The authors declare that there is no acknowledgment to disclose.

References

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Details

Primary Language

English

Subjects

Surgery (Other)

Journal Section

Research Article

Authors

Emrah Şahin ^*
0000-0001-5267-9068
Türkiye

Ender Anılır
0000-0002-0024-1790
Türkiye

Abuzer Dirican
0000-0002-8647-3268
Türkiye

Bülent Ünal
0000-0002-7965-1716
Türkiye

Publication Date

September 3, 2026

Submission Date

January 4, 2026

Acceptance Date

March 24, 2026

Published in Issue

Year 2026 Volume: 65 Number: 3

DOI

https://doi.org/10.19161/etd.1855183

IZ

https://izlik.org/JA69JC85AP

Cite

RIS / Bibtex

APA

Şahin, E., Anılır, E., Dirican, A., & Ünal, B. (2026). Can preoperative thrombocytopenia be a risk indicator for emergency surgery due to liver transplant complications? Ege Tıp Dergisi, 65(3), 386-393. https://doi.org/10.19161/etd.1855183

AMA

1.Şahin E, Anılır E, Dirican A, Ünal B. Can preoperative thrombocytopenia be a risk indicator for emergency surgery due to liver transplant complications? EJM. 2026;65(3):386-393. doi:10.19161/etd.1855183

Chicago

Şahin, Emrah, Ender Anılır, Abuzer Dirican, and Bülent Ünal. 2026. “Can Preoperative Thrombocytopenia Be a Risk Indicator for Emergency Surgery Due to Liver Transplant Complications?”. Ege Tıp Dergisi 65 (3): 386-93. https://doi.org/10.19161/etd.1855183.

EndNote

Şahin E, Anılır E, Dirican A, Ünal B (September 1, 2026) Can preoperative thrombocytopenia be a risk indicator for emergency surgery due to liver transplant complications? Ege Tıp Dergisi 65 3 386–393.

IEEE

[1]E. Şahin, E. Anılır, A. Dirican, and B. Ünal, “Can preoperative thrombocytopenia be a risk indicator for emergency surgery due to liver transplant complications?”, EJM, vol. 65, no. 3, pp. 386–393, Sept. 2026, doi: 10.19161/etd.1855183.

ISNAD

Şahin, Emrah - Anılır, Ender - Dirican, Abuzer - Ünal, Bülent. “Can Preoperative Thrombocytopenia Be a Risk Indicator for Emergency Surgery Due to Liver Transplant Complications?”. Ege Tıp Dergisi 65/3 (September 1, 2026): 386-393. https://doi.org/10.19161/etd.1855183.

JAMA

1.Şahin E, Anılır E, Dirican A, Ünal B. Can preoperative thrombocytopenia be a risk indicator for emergency surgery due to liver transplant complications? EJM. 2026;65:386–393.

MLA

Şahin, Emrah, et al. “Can Preoperative Thrombocytopenia Be a Risk Indicator for Emergency Surgery Due to Liver Transplant Complications?”. Ege Tıp Dergisi, vol. 65, no. 3, Sept. 2026, pp. 386-93, doi:10.19161/etd.1855183.

Vancouver

1.Emrah Şahin, Ender Anılır, Abuzer Dirican, Bülent Ünal. Can preoperative thrombocytopenia be a risk indicator for emergency surgery due to liver transplant complications? EJM. 2026 Sep. 1;65(3):386-93. doi:10.19161/etd.1855183