The following is a summary of “Low viscoelastic clot strength, platelet transfusions, and graft dysfunction are associated with persistent postoperative ascites following liver transplantation,” published in the December 2022 issue of Surgery by Jiang, et al.

Following a liver transplant (LT), high output, persistent ascites (PA) is a typical consequence. According to recent research, platelets can reduce leakage in diseased situations and assist in maintaining endothelial integrity. For a study, researchers sought to evaluate the relationship between PA post-LT and platelet count and function.

Thrombelastography (TEG) was used to quantify clot strength (MA), a gauge of platelet activity. Following surgery, total drain output was measured at 24-hour intervals throughout the same period as TEG. To prevent drain removal, PA was deemed to be >1 L on POD7.

Prospectively recruited were 105 LT patients with moderate to high volume preoperative ascites. PA was present in 28%. Platelet transfusions both before and after surgery, along with the POD5 TEG MA and POD5 MELD score, were linked to PA. Patients with PA spent more time in the hospital and had more intraabdominal infections.

After a liver transplant, persistent ascites were typically linked to platelet transfusions, weak clots, and graft failure.

Reference: americanjournalofsurgery.com/article/S0002-9610(22)00624-9/fulltext