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No evidence for systemic platelet activation during or after orthotopic liver transplantation
Author(s) -
Pereboom Ilona T. A.,
Adelmeijer Jelle,
van Leeuwen Yvonne,
Hendriks Herman G. D.,
Porte Robert J.,
Lisman Ton
Publication year - 2009
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21776
Subject(s) - platelet , platelet activation , liver transplantation , medicine , beta thromboglobulin , transplantation , platelet membrane glycoprotein , receptor , integrin , flow cytometry , immunology , platelet factor 4 , endocrinology
Platelet function is thought to deteriorate during liver transplantation as a result of platelet activation and proteolysis of platelet receptors by plasmin following reperfusion. However, this hypothesis has never been formally tested. Twenty patients undergoing a first or second liver transplant were included in the study. Blood samples were taken at standardized time points during transplantation and up to 10 days after transplantation. Platelet activation was assessed by detection of the activation markers P‐selectin and activated integrin αIIbβ3 with flow cytometry. Proteolytic cleavage of platelet receptors was assessed by flow cytometry measurement of the constitutively expressed platelet receptors glycoprotein Ibα and integrin αIIbβ3. In addition, using enzyme‐linked immunosorbent assay techniques, we measured plasma levels of platelet activation products β‐thromboglobulin and platelet factor 4 and plasma levels of cleaved fragments of glycoproteins Ibα and V. Flow cytometry analyses provided no evidence of substantial platelet activation during transplantation. In fact, the expression of activated integrin αIIbβ3 decreased postoperatively; this indicated that platelets were in a slightly activated state prior to surgery. Plasma levels of β‐thromboglobulin and platelet factor 4 also substantially decreased after transplantation. In addition, no changes were observed in the constitutively expressed platelet receptors or in the plasma levels of platelet receptor fragments, and this indicated a lack of substantial receptor proteolysis. In conclusion, no evidence was found for significant activation of circulating blood platelets or the proteolysis of key platelet receptors during liver transplantation. These findings suggest that the platelet functional capacity does not decrease during liver transplantation. Liver Transpl 15:956–962, 2009. © 2009 AASLD.