Impedance Aggregometry Reveals Increased Platelet Aggregation during Liver Transplantation

In patients presenting for liver transplantation, increased platelet aggregation as well as thrombocytopenia have been demonstrated, but bedside assays have not been investigated. We compared platelet aggregation in liver transplantation patients and control surgical patients using impedance aggrego...

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Main Authors: Mohamed Soliman, Matthias Hartmann
Format: Article
Language:English
Published: MDPI AG 2019-10-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/8/11/1803
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spelling doaj-7f9f989327e545fc96104a35c58d4d352020-11-25T02:13:42ZengMDPI AGJournal of Clinical Medicine2077-03832019-10-01811180310.3390/jcm8111803jcm8111803Impedance Aggregometry Reveals Increased Platelet Aggregation during Liver TransplantationMohamed Soliman0Matthias Hartmann1Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Universität Duisburg-Essen, 45122 Essen, GermanyKlinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Universität Duisburg-Essen, 45122 Essen, GermanyIn patients presenting for liver transplantation, increased platelet aggregation as well as thrombocytopenia have been demonstrated, but bedside assays have not been investigated. We compared platelet aggregation in liver transplantation patients and control surgical patients using impedance aggregometry. We hypothesized that platelet activity is not altered during liver transplantation. After the allowance of the ethics committee, platelet aggregation was determined using impedance aggregometry with the activators ristocetin, adenosine diphosphate (ADP), arachidonic acid, collagen, and thrombin receptor-activating peptide (TRAP) in liver transplantation patients at four time points (start of surgery, anhepatic phase, reperfusion, end of surgery) and in control surgical patients. Moreover, platelet count was determined using a Coulter counter. To compensate for the thrombocytopenia often present in patients presenting for liver transplantation, the ratio between impedance aggregometry finding and platelet count was used. For statistical evaluation, the <i>t</i>-test or the Mann&#8722;Whitney U-test were used, as appropriate. Platelet aggregation ratio showed a 3.1-fold increase in liver transplantation patients (<i>n</i> = 37) in comparison to control surgical patients (<i>n</i> = 10) when ristocetin was used as the activator (<i>p</i> = 0.001). Moreover, an approximately twofold increase of ADP-, arachidonic acid-, collagen-, and TRAP-induced platelet aggregation ratio was determined. Platelet aggregation normalized at the end of the transplantation procedure. Impedance aggregometry revealed a markedly increased platelet aggregation in some liver transplantation patients and might be suitable to guide platelet transfusion and antiplatelet therapy.https://www.mdpi.com/2077-0383/8/11/1803liver transplantationplatelet aggregationimpedance aggregometrymultiplate™von willebrand factorristocetin
collection DOAJ
language English
format Article
sources DOAJ
author Mohamed Soliman
Matthias Hartmann
spellingShingle Mohamed Soliman
Matthias Hartmann
Impedance Aggregometry Reveals Increased Platelet Aggregation during Liver Transplantation
Journal of Clinical Medicine
liver transplantation
platelet aggregation
impedance aggregometry
multiplate™
von willebrand factor
ristocetin
author_facet Mohamed Soliman
Matthias Hartmann
author_sort Mohamed Soliman
title Impedance Aggregometry Reveals Increased Platelet Aggregation during Liver Transplantation
title_short Impedance Aggregometry Reveals Increased Platelet Aggregation during Liver Transplantation
title_full Impedance Aggregometry Reveals Increased Platelet Aggregation during Liver Transplantation
title_fullStr Impedance Aggregometry Reveals Increased Platelet Aggregation during Liver Transplantation
title_full_unstemmed Impedance Aggregometry Reveals Increased Platelet Aggregation during Liver Transplantation
title_sort impedance aggregometry reveals increased platelet aggregation during liver transplantation
publisher MDPI AG
series Journal of Clinical Medicine
issn 2077-0383
publishDate 2019-10-01
description In patients presenting for liver transplantation, increased platelet aggregation as well as thrombocytopenia have been demonstrated, but bedside assays have not been investigated. We compared platelet aggregation in liver transplantation patients and control surgical patients using impedance aggregometry. We hypothesized that platelet activity is not altered during liver transplantation. After the allowance of the ethics committee, platelet aggregation was determined using impedance aggregometry with the activators ristocetin, adenosine diphosphate (ADP), arachidonic acid, collagen, and thrombin receptor-activating peptide (TRAP) in liver transplantation patients at four time points (start of surgery, anhepatic phase, reperfusion, end of surgery) and in control surgical patients. Moreover, platelet count was determined using a Coulter counter. To compensate for the thrombocytopenia often present in patients presenting for liver transplantation, the ratio between impedance aggregometry finding and platelet count was used. For statistical evaluation, the <i>t</i>-test or the Mann&#8722;Whitney U-test were used, as appropriate. Platelet aggregation ratio showed a 3.1-fold increase in liver transplantation patients (<i>n</i> = 37) in comparison to control surgical patients (<i>n</i> = 10) when ristocetin was used as the activator (<i>p</i> = 0.001). Moreover, an approximately twofold increase of ADP-, arachidonic acid-, collagen-, and TRAP-induced platelet aggregation ratio was determined. Platelet aggregation normalized at the end of the transplantation procedure. Impedance aggregometry revealed a markedly increased platelet aggregation in some liver transplantation patients and might be suitable to guide platelet transfusion and antiplatelet therapy.
topic liver transplantation
platelet aggregation
impedance aggregometry
multiplate™
von willebrand factor
ristocetin
url https://www.mdpi.com/2077-0383/8/11/1803
work_keys_str_mv AT mohamedsoliman impedanceaggregometryrevealsincreasedplateletaggregationduringlivertransplantation
AT matthiashartmann impedanceaggregometryrevealsincreasedplateletaggregationduringlivertransplantation
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