Spleen volume and platelet count changes among donors after living donor liver transplantation

Background/Aims: The long term changes in and the relation of spleen volume and platelet counts after liver graft harvest in living donors is still unknown. The purpose of this study is to compare spleen volume and platelet count changes among living donors of different types of liver graft harvest (group RL, right lobectomy; group LH, left hepatectomy). Methodology: Between June 1994 and December 2004, 205 healthy individuals donated part of their liver to 204 liver transplant recipients which included 1 re-transplantation and 1 dual-graft transplantation. The pre-liver donation and 6 months postliver donation spleen volumes were measured. The platelet counts were determined on the pre-donation day, post-donation day, the end of the 2nd week post-donation, the 6th month post-donation, and at 1 year after donation. Results: There was no difference in the spleen volume in the different groups at pre-donation. There was a significant increase in the spleen volumes in both groups at 6 months post-donation. The post-operative spleen volumes were significantly larger in group RL than in group LH. The average spleen ratio (S_6m/ _S0) and spleen change rate (ΔS) were also significantly larger in group RL. The platelet counts were all decreased in the first 3 days post-donation in both groups. From the 2nd week to the 6th month post-donation, the platelet counts gradually decreased and were near preoperative values by 6 months. Significantly, there was lower platelet counts noted starting on the 2nd postoperative day until 6 months post-donation in group RL. There was no significant difference between the levels of platelet counts in both groups at 1-year post-donation. Conclusions: a significant increase in spleen volumes was noted in most donors 6 months after partial liver donation. The spleen volume change may be proportional to the size of the hepatectomy. Postdonation, the platelet counts decrease. The spleen volume change is one factor affecting platelet count change.