DURING the last four years, ten patients with liver disease have been treated at the University of Colorado with either orthotopic or auxiliary hepatic homotransplantation.1,2 A hemorrhagic diathesis, explained at least partially by increased circulating fibrinolysins,3 frequently complicated the operative procedure. Derangements in other clotting factors are also known to occur,3,4 but the presence of thrombocytopenia during the early postoperative period has not been well documented.
In the present study, platelet changes in the clinical cases are reviewed. In addition, the magnitude, timing, and duration of thrombocytopenia have been evaluated under controlled circumstances in untreated dogs subjected to orthotopic transplantation, as well as in comparable experiments in which various immunosuppressive agents were provided including antilymphocyte globulin, azathioprine, and prednisone.
Clinical Studies.—Three attempts at auxiliary transplantation were performed: One patient died two hours after operation and the other two lived for 22 and 34 days, respectively.