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Avatrombopag for Severe Thrombocytopenia After Liver Transplantation: A Retrospective Cohort Study

16. maj 2026 opdateret af: Shanghai Zhongshan Hospital

Effectiveness and Safety of Avatrombopag for Severe Post-Transplantation Thrombocytopenia in Liver Transplant Recipients: A Propensity-Score Matched Retrospective Cohort Study

Severe post-transplantation thrombocytopenia (platelet count <30×10⁹/L) occurs frequently after liver transplantation (LT) and is associated with increased bleeding risk, allograft dysfunction, and transfusion-related complications. Avatrombopag, an oral thrombopoietin receptor agonist, is approved for thrombocytopenia in chronic liver disease but its role in the post-LT setting remains unclear. This retrospective cohort study included adult LT recipients who developed severe post-transplantation thrombocytopenia (SPT) between November 2019 and August 2025. After 1:1 propensity score matching (nearest neighbor, caliper = 0.2 SD of the logit of the propensity score) for age, sex, etiology of liver disease, cold ischemia time (CIT), intraoperative blood loss (IBL), preoperative platelet count, and Model for End-stage Liver Disease (MELD) score, 67 patients who received avatrombopag (20 mg/day for 5 days) were compared with 67 matched controls who received standard care. The primary outcome was platelet rise rate (×10⁹/L/day). Secondary outcomes included absolute platelet increase, blood product utilization, concomitant thrombopoietic agent use, and 30-day complications (thrombosis, infection, mechanical ventilation, renal replacement therapy, death).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

134

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Kina
    • Shanghai Municipality
      • Shanghai, Shanghai Municipality, Kina, 200032
        • Zhongshan Hospital, Fudan University

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult patients who underwent liver transplantation at Zhongshan Hospital, Fudan University between November 2019 and August 2025

Beskrivelse

Inclusion Criteria: (1) were aged 18 years or older; and (2) developed severe post transplantation thrombocytopenia (SPT), defined as a nadir platelet count below 30×10⁹/L within the first 7 days after LT.

Exclusion criteria: (1) use of avatrombopag within 4 weeks before LT; (2) second or subsequent LT; (3) death from surgical complications within 7 days after LT; (4) incomplete platelet measurement records; and (5) age younger than 18 years.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Arm 1: Avatrombopag Group / Arm 2: Control Group

Arm 1: Avatrombopag Group. Standard postoperative care with 20 mg orally once daily for 5 days, initiated when postoperative platelet count fell below 30×10⁹/L.

Arm 2: Control Group. Standard postoperative care without avatrombopag
Medicin: Avatrombopag 20 mg Oral Tablet
20 mg orally once daily for 5 days, initiated when postoperative platelet count fell below 30×10⁹/L after liver transplatation

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
platelet rise rate
Tidsramme: 30 days post-LT
The platelet rise rate was calculated as (postoperative peak platelet count - postoperative nadir platelet count) divided by (time to peak - time to nadir + 1), measured in ×10⁹/L/day.
30 days post-LT

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Absolute platelet increase (×10⁹ cells/L)
Tidsramme: 30 days post-Liver transplatation
Postoperative peak minus postoperative nadir.
30 days post-Liver transplatation
Red blood cell transfusion volume (units)
Tidsramme: 30 days post-Liver transplatation
Units of packed red blood cells transfused within 30 days after LT.
30 days post-Liver transplatation
Platelet transfusion volume (bags)
Tidsramme: 30 days post-Liver transplatation
Bags of platelets transfused within 30 days after LT.
30 days post-Liver transplatation
Concomitant thrombopoietic agent use
Tidsramme: 30 days post-Liver transplatation
Use of other thrombopoietic agents (e.g., recombinant human thrombopoietin), recorded as binary (yes/no).
30 days post-Liver transplatation
Infection (culture-proven + symptoms)
Tidsramme: 30 days post-Liver transplatation
Presence of culture-confirmed infection with accompanying clinical symptoms within 30 days after LT.
30 days post-Liver transplatation
Mechanical ventilation requirement
Tidsramme: 30 days post-Liver transplatation
Requirement for postoperative mechanical ventilation support.
30 days post-Liver transplatation
Renal replacement therapy requirement
Tidsramme: 30 days post-Liver transplatation
Requirement for postoperative dialysis.
30 days post-Liver transplatation
Thrombotic events
Tidsramme: 30 days post-Liver transplatation
Deep vein thrombosis or hepatic artery thrombosis.
30 days post-Liver transplatation
30-day mortality
Tidsramme: 30 days post-Liver transplatation
All-cause death within 30 days after liver transplantation.
30 days post-Liver transplatation

Samarbejdspartnere og efterforskere

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Sponsor

Shanghai Zhongshan Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. november 2019

Primær færdiggørelse (Faktiske)

31. august 2025

Studieafslutning (Faktiske)

31. august 2025

Datoer for studieregistrering

Først indsendt

16. maj 2026

Først indsendt, der opfyldte QC-kriterier

16. maj 2026

Først opslået (Faktiske)

22. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

22. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

16. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • B2026-303

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

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Kliniske forsøg med Postoperativ komplikation

Kliniske forsøg med Avatrombopag 20 mg Oral Tablet

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