Plasma thrombopoietin level after liver transplantation: relationship to cold ischemia time and coagulation parameters.

OBJECTIVE: To determine the relation between thrombopoietin (Tpo) levels following orthotopic liver transplantation (OLT), cold ischemia time and postoperative peripheral blood platelet count and prothrombin activity. DESIGN: Prospective clinical study. SETTING: Intensive care unit. PATIENTS: Fourteen patients with uncomplicated postoperative course after OLT. MEASUREMENTS AND RESULTS: Plasma Tpo, as quantified by enzyme immunoassay, rose significantly from 194.9 +/- 45.7 pg/ml on day 1 after OLT to a peak value of 500.7 +/- 94.1 pg/ml on day 5 while platelet count was below normal values. Then the platelet count increased and reached normal values while Tpo decreased to normal. The rise of Tpo levels was associated with normalization of prothrombin time but peak Tpo concentrations were in inverse correlation with cold ischemia times. CONCLUSION: The extent of production of Tpo in the liver graft following OLT is affected by cold ischemia time. This observation may be applicable in the prevention of bleeding complications associated with postoperative thrombocytopenia.