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Platelet recovery correlates parenchymal volume recovery after liver resection
Author(s) -
Yamazaki Shintaro,
Takayama Tadatoshi,
Mitsuka Yusuke,
Aoki Masaru,
Midorikawa Yutaka,
Moriguchi Masamichi,
Higaki Tokio
Publication year - 2020
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13488
Subject(s) - liver regeneration , platelet , parenchyma , medicine , hepatectomy , resection , liver function , computed tomography , recovery rate , regeneration (biology) , gastroenterology , surgery , pathology , biology , microbiology and biotechnology , chemistry , chromatography
Aim Platelet count seems to assess liver function and predict liver regeneration, but factors associated with liver regeneration remain unclear. This study analyzed the relationship between platelet recovery and postresection liver regeneration. Methods Data from 343 candidates from 1245 consecutive patients with liver resection of more than Couinaud's segments were analyzed. Patients were divided into a low‐platelet‐recovery rate (LPRR) group (lowest 25%) or a control group on the basis of the platelet recovery rate on postoperative day (POD)7. Data were matched before analysis to adjust for operation scale. Trends in liver functional recovery were assessed, and liver volume recovery and remnant ischemic area was calculated using computed tomography volumetry. Factors predicting liver regeneration were analyzed. Results In 78 matched‐pair patients, the all‐complications rate (42.3% vs. 26.9%, P = 0.002) and infectious complications rate (21.8% vs. 9.0%, P = 0.027) were significantly higher in the LPRR group than in controls. Trends in liver functional recovery did not differ significantly, whereas significant differences remained for platelet recovery. Parenchyma volume recovery was delayed in the LPRR group from POD7 (84.5% vs. 78.1, P < 0.01) to POD30 (92.5% vs. 85.6, P < 0.01). Platelet recovery rate on POD7 correlated negatively with ischemic liver volume as evaluated on POD2 by computed tomography (r = 0.691). Postoperative ischemic volume on POD2 (5.41 [1.98–11.21], P < 0.001), infectious complications (3.48 [1.44–7.37], P < 0.001), and multiple resection (1.67 [1.10–4.11], P = 0.011) predicted delayed platelet recovery rate on multivariate analysis. Conclusion Platelet recovery correlated with liver volume recovery and occurrence of complications. Large ischemic area might negatively impact regeneration after liver resection.