{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:02:15Z","timestamp":1792270935327,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,3,12]],"date-time":"2018-03-12T00:00:00Z","timestamp":1520812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/J006742\/1"],"award-info":[{"award-number":["MR\/J006742\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Thrombocytopenia and circulating dysfunctional immune cells are commonly observed in patients with cirrhosis. Platelets may form complexes with neutrophils, monocytes and T cells modulating their function. We recently reported increased frequencies of platelet\u2010complexed neutrophils in cirrhosis with evidence of neutrophil activation upon contact with healthy platelets in vitro. Whether this occurs in vivo following platelet transfusion and contributes to systemic inflammation and endothelial activation is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To characterise platelet\u2010leucocyte aggregation in cirrhosis and to determine whether elective platelet transfusion results in perturbations associated with changes in markers of haemostasis, inflammation or endothelial activation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected blood from cirrhotics (n = 19) before and following elective platelet transfusion. We measured platelet\u2010leucocyte aggregation, activation and function, and markers of platelet activation, systemic inflammation and endothelial activation by flow cytometry. Haemostasis was assessed by thromboelastometry and plasma haemostatic proteins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed a 2.5\u2010fold increase in platelet\u2010complexed neutrophils in patients with cirrhosis compared with healthy subjects and twofold more platelets attached per monocyte and T cell. All platelet\u2010complexed leucocytes expressed higher levels of activation markers and platelet\u2010complexed neutrophils had higher resting oxidative burst and phagocytic capacity than their nonplatelet\u2010complexed counterparts (<jats:italic>P<\/jats:italic> &lt; 0.001); most pronounced in patients with cirrhosis. Paradoxically, platelet\u2010complexed leucocyte frequency decreased with increasing <jats:styled-content style=\"fixed-case\">MELD<\/jats:styled-content> score. Platelet transfusion increased soluble <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>40 ligand (platelet activation marker), the frequency of platelet\u2010complexed monocytes (<jats:italic>P<\/jats:italic> &lt; 0.05) and improved haemostatic status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cirrhotic patients have activated circulating platelet\u2010complexed leucocytes with increased platelet\u2010monocyte aggregation following elective platelet transfusion. Elective platelet transfusion might therefore exacerbate immune dysfunction in cirrhosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14600","type":"journal-article","created":{"date-parts":[[2018,3,12]],"date-time":"2018-03-12T09:52:39Z","timestamp":1520848359000},"page":"1375-1386","source":"Crossref","is-referenced-by-count":25,"title":["Platelet\u2010leucocyte aggregation is augmented in cirrhosis and further increased by platelet transfusion"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1630-8395","authenticated-orcid":false,"given":"S.","family":"St\u00f8y","sequence":"first","affiliation":[{"name":"Institute of Liver Studies and Transplantation King's College London School of Medicine at King's College Hospital London UK"},{"name":"Department of Hepatology and Gastroenterology Aarhus University Hospital Aarhus C Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. C.","family":"Patel","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies and Transplantation King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. P.","family":"Sturgeon","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies and Transplantation King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. K.","family":"Manakkat Vijay","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies and Transplantation King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3503-7140","authenticated-orcid":false,"given":"T.","family":"Lisman","sequence":"additional","affiliation":[{"name":"Surgical Research Laboratory University of Groningen University Medical Center Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Bernal","sequence":"additional","affiliation":[{"name":"Liver Intensive Care Unit King's College London School of Medicine at King's College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6133-4619","authenticated-orcid":false,"given":"D. 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