Association of Platelet Count and Platelet Transfusion With Serotonin Level During Living Donor Liver Transplantation: Possible Connection to Graft Regeneration
Association of Platelet Count and Platelet Transfusion With Serotonin Level During Living Donor Liver Transplantation: Possible Connection to Graft Regeneration
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DOI：
10.1016/j.transproceed.2018.02.035
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发表时间：
2018-05-01
影响因子：
0.9
通讯作者：
Kim, G. S.
中科院分区：
文献类型：
--
作者：
Han, S.;Ko, J. S.;Kim, G. S.
背景。我们最近发现，肝移植期间血小板计数和血小板输注量与早期移植物再生呈正相关。据推测，血小板衍生的血清素介导肝脏再生。目标。本研究旨在探讨术中血小板计数、血小板输注与血清5 -羟色胺水平的关系。32名接受活体肝移植的受者被纳入这项前瞻性观察研究。在麻醉诱导、无肝期开始、移植物再灌注前、移植物再灌注后5分钟/1小时/3小时/5小时、输血小板前/后分别测定血清血小板计数和血清素水平。采用液相色谱串联质谱法测定血清素。麻醉诱导时血清素水平为24.5 μ g/mL（四分位数范围14.6 ~ 38.1 μ g/mL）。手术过程中，血小板计数和血清素水平的一系列变化呈现相似的趋势：在无肝期下降，移植物再灌注后1小时上升，随后逐渐下降。血清素水平与血小板计数呈正相关（相关系数= 0.620,P < 0.001）。输血后血小板计数由22 （19-31）× 10(9)/L增加至53 （50-81）× 10(9)/L (P = 0.008)，血清血清素由11.04 (6.41-15.34)μ g/mL增加至34.26 (25.86-41.94)μ g/mL （P = 0.008）。我们的研究结果表明，同种异体血小板可以作为血清素的效应细胞。此外，我们的研究结果支持了血小板与移植后移植物再生之间的关联是由血清素介导的假设。需要进一步研究血清素和其他血小板衍生分子在肝脏再生中的作用。
Background. We recently showed that platelet counts and the amount of platelet transfusion during liver transplantation are positively associated with early graft regeneration. It was hypothesized that platelet-derived serotonin mediates liver regeneration. Objectives. This study aimed to evaluate the association between intraoperative platelet count, platelet transfusion, and serum serotonin level.Methods. Thirty-two recipients undergoing living-donor liver transplantation were enrolled into this prospective observational study. Serum platelet counts and serotonin levels were measured at the following times: anesthetic induction, start of the anhepatic phase, before graft reperfusion, 5 minutes/1 hour/3 hours/5 hours after graft reperfusion, and before/after platelet transfusion. Serotonin was measured by using a liquid chromatography tandem mass spectrometry.Results. Serotonin level at the anesthetic induction was 24.5 mu g/mL (interquartile range, 14.6 to 38.1 mu g/mL). During surgery, serial changes in platelet counts and serotonin levels showed a similar trend: they decreased during the anhepatic phase, increased during the first hour after graft reperfusion, and thereafter gradually decreased. Serotonin level was positively correlated with platelet counts (correlation coefficient = 0.620, P < .001). Allogeneic platelet transfusion significantly increased platelet count from 22 (19-31) x 10(9)/L to 53 (50-81) x 10(9)/L (P = .008) and it also increased serum serotonin from 11.04 (6.41-15.34) mu g/mL to 34.26 (25.86-41.94) mu g/mL (P = .008).Conclusions. Our findings indicate that allogeneic platelets could act as effector cells deriving serotonins. Also, our findings support the hypothesis that the association between platelets and post-transplantation graft regeneration is mediated by serotonin. Further studies are warranted regarding the respective role of serotonin and other platelet derived molecules mediating liver regeneration.