Immediate postoperative low platelet count is associated with liver failure after partial hepatectomy in patients with hepatocellular carcinoma

Objective To investigate the correlation between immediate postoperative platelet count with liver failure after partial hepatectomy in patients with hepatocellular carcinoma. Methods The clinical data of 71 patients with hepatocellular carcinoma who underwent liver resection at the Hepatopancreatobiliary Surgery Department of Nanjing Drum Tower Hospital from July 2013 to August 2015 were retrospectively analyzed. The clinical diagnosis was confirmed by pathology of the resected specimens. Based on postoperative platelet count within 2 h, the patients were divided into the low platelet count (PLT<100×109/L= group (n=24, 33.8%) and the normal platelet count (PLT≥100×109/L) group (n=47, 66.2%). The correlations between immediate postoperative platelet count with serum indexes including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Tbil) and direct bilirubin (Dbil) were analyzed, and the incidences of posthepatectomy liver failure was also evaluated in these two groups. Results There was no re-operation and perioperative death in this study. Among the 71 patients, 25 patients (35.2%) developed postoperative complications (grade Ⅰ to Ⅲ), and 8 patients (11.3%) suffered from postoperative liver failure (grade A). When compared with the normal platelet count group, the low platelet count group had significantly increased risks of postoperative liver failure (29.2% vs 2.1%, χ2=11.618, P<0.05), increased postoperative peaks of ALT, AST, Tbil and Dbil levels [(462.5±135.7)U/L vs (307.9±192.6)U/L, (440.0±163.3)U/L vs (265.8±155.8)U/L, (29.5±9.1)μmol/L vs (17.9±8.8)μmol/L, t=3.507, 4.385, 5.129, P<0.05, respectively] and longer normalization time of liver function. Multiple Logistic regression analyses revealed that an immediate postoperative low platelet count was an independent risk factor of posthepatectomy liver failure. Conclusions The platelet count was associated with the incidence of postoperative liver failure after partial liver resection in patients with hepatocellular carcinoma. Patients with an immediate postoperative low platelet count suffered from a high incidence of posthepatectomy liver failure and delayed liver function recovery. Key words: Hepatocellular carcinoma; Liver resection; Platelet count; Liver regeneration