Key result
Prolonged platelet function analyzer closure time was not associated with calculated blood loss in patients undergoing liver resection (HR 1.06; P=0.881).
Why the study?
The role of the platelet function analyzer in predicting the perioperative risk of bleeding in patients undergoing liver resection remains controversial.
Does the platelet function test (PFA-200) predict blood loss in patients undergoing hepatic resection for hepatocellular carcinoma?
Cohort (n=372)
No
Does the platelet function test (PFA-200) predict blood loss in patients undergoing hepatic resection for hepatocellular carcinoma?
Hazard Ratio: 1.06
p-value: p=0.881
Routine use of the platelet function analyzer (PFA-200) is not recommended for predicting blood loss in patients undergoing liver resection who are not on antiplatelet agents or lack chronic kidney disease.
PFA-200 closure time does not predict blood loss after liver resection; leaves open utility of platelet testing in hepatic surgery.
Purpose: The platelet function analyzer (PFA)-100/200 is widely used to assess platelet function. However, its role in predicting the perioperative risk of bleeding in patients undergoing liver resection remains controversial. Therefore, we aimed to ascertain whether the platelet function test could be useful in predicting bleeding risk in patients undergoing hepatic surgery. Methods: The study participants were patients who underwent hepatectomy for hepatocellular carcinoma at our hospital over a period of 10 years from January 1, 2010 to May 31, 2020. PFA-200 values of these patients were divided into 2 groups; normal (n = 333) and prolonged (n = 39). Results: 0.46 ± 1.97 units, P = 0.306) were similar between the 2 groups, respectively. Multivariate analysis revealed no association between PFA closure time and calculated blood loss (hazard ratio, 1.06; P = 0.881). Moreover, there was no association between PFA closure time and preoperative laboratory results or assessment of tool-related liver function in multivariate analysis. Conclusion: There was no correlation between the amount of blood loss and platelet function in patients who underwent liver resection. In patients undergoing liver resection who are not managed on antiplatelet agents or do not have chronic kidney disease, the use of routine PFA is not recommended.
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Gwon et al. (2022) conducted a cohort in Hepatocellular carcinoma undergoing hepatectomy (n=372). Prolonged PFA closure time vs. Normal PFA closure time was evaluated on Calculated blood loss (HR 1.06, p=0.881). Prolonged platelet function analyzer closure time was not associated with calculated blood loss in patients undergoing liver resection (HR 1.06; P=0.881).
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