Introduction

Chronic liver disease is a national problem with over 3 million American suffering from end stage liver disease. The majority of patients with advanced liver disease have pancytopenia due to multiple factors. Hematology consults generated by the hematologic effects of end stage liver disease comprise 10-20% of consults. The majority of patients undergoing orthotopic liver transplantation achieve some degree of partial or complete hematologic recovery.

Methods

196 sequential records for patients undergoing orthotopic liver transplantation were analyzed. Complete data was available for 92 patients. Hematologic parameters were reviewed 1 month prior to transplantation, 1 month post, 1 year and 2 year post transplantation. A statistical analysis was performed using the two tailed t-test method.

Results

Rapid and sustained hematologic recovery occurred in the majority of patients and was significant except for WBC at 24 months.

Conclusions

Orthotopic liver transplantation results in rapid sustained hematologic response in the majority of patients. Rapid recovery of platelet counts was most significant and does not reflect Ssplenectomy. Co-morbidity and anti-rejection drugs also may lead to delayed marrow suppression. Further sub-set analysis and measure of additional factors will also be presented.

Disclosures:

No relevant conflicts of interest to declare.

Table 1

CBC Measurements Post Liver Transplantation (months) N=92

0 month1 month12 month24 month
Hgb (g/dL) 11.2 10.3 12.1 12.9 
(SD)[p] (2.3) (1.4)[0.00] (1.6)[0.00] (3.0)[0.00] 
HCT (%) 32.4 30.3 35.8 37.7 
(SD)[p] (7.1) (4.0)[0.02] (5.0)[0.00] (6.1)[0.00] 
Platelets(109/L) 87 235 141 148 
(SD)[p] (63) (225)[0.00] (55)[0.00] (57)[0.00] 
WBC(103/cc) 6.4 7.7 5.0 5.7 
(SD)[p] (4.1) (3.4)[0.01] (2.2)[0.002] (2.5)[0.12] 
0 month1 month12 month24 month
Hgb (g/dL) 11.2 10.3 12.1 12.9 
(SD)[p] (2.3) (1.4)[0.00] (1.6)[0.00] (3.0)[0.00] 
HCT (%) 32.4 30.3 35.8 37.7 
(SD)[p] (7.1) (4.0)[0.02] (5.0)[0.00] (6.1)[0.00] 
Platelets(109/L) 87 235 141 148 
(SD)[p] (63) (225)[0.00] (55)[0.00] (57)[0.00] 
WBC(103/cc) 6.4 7.7 5.0 5.7 
(SD)[p] (4.1) (3.4)[0.01] (2.2)[0.002] (2.5)[0.12] 
View Large
Topics:
liver transplantation, liver transplant, orthotopic, end stage liver disease, transplantation, bone marrow suppression, chief complaint, hemoglobin, liver disease, chronic, liver diseases, pancytopenia

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2013 by The American Society of Hematology
2013
Sign in via your Institution