Background: Despite advances in surgical technique and anaesthetic management, perioperative bleeding remains one of the main causes of increased mortality and morbidity in adult patients (pts) undergoing liver transplantation (LT). Few studies have suggested that greater mean platelet volume (MPV) can predispose to thrombotic events. However so far there were no studies to evaluate the predictive value of MPV on perioperative blood loss in pts undergoing solid organ transplantation.
Objectives: We sought to determine the prognostic value of MPV for blood transfusion requirements in adult patients undergoing LT.
Material and methods: We have prospectively enrolled 78 adult pts undergoing cadaveric LT at Medical University of Warsaw. Pts were recruited from August 2012 until March 2014. Written informed consent was obtained from all pts. Blood samples for MPV measurement were obtained at admission before LT. The primary end point was the number of units of red blood cells (RBC), fresh frozen plasma (FFP), platelet concentrates (PLT) and cryoprecipitate transfused during LT.
Results: The median value of MPV in the study group was 10,9 fl (range 7,2-13,1 fl). There was no correlation between MPV and platelet count. Multivariate linear regression analysis showed that MPV was independently associated with the number of RBC transused intraoperatively (β=-0,234; p=0,44). Similar analysis for intraoperative FFP transfusion showed a trend towards increased FFP requirements with decreased MPV (β=-0,185; p=0,086). MPV did not predict intraoperative PLT transfusion requirements, however it was a significant predictor for cryoprecipitate transfusion during LT (β=-0,236; p=0,033).
Conclusions: This is the first study to demonstrate that mean platelet volume is significant and independent predictor of increased blood transfusion requirements during LT in adult pts. Except for its prognostic value it may also carry further therapeutic implications. However the mechanistic link of this observation needs to be further elucidated.

Mean platelet volume predicts increased blood transfusion requirements in adult patients undergoing liver transplantation