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No increase in blood transfusions during liver transplantation since the withdrawal of aprotinin
Author(s) -
Schofield Nick,
Sugavanam Anita,
Thompson Karen,
Mallett Susan V.
Publication year - 2014
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.23839
Subject(s) - medicine , fibrinolysis , aprotinin , cryoprecipitate , tranexamic acid , liver transplantation , propensity score matching , fresh frozen plasma , surgery , transplantation , blood transfusion , group b , antifibrinolytic , liver disease , anesthesia , gastroenterology , platelet , blood loss
The aims of this study were to determine whether the withdrawal of aprotinin (APRO) led to an increased bleeding risk in patients undergoing orthotopic liver transplantation (OLT). A retrospective analysis compared consecutive patients undergoing OLT and treated with aprotinin (APRO group; n = 100) with a group in which aprotinin was not used (no‐APRO group; n = 100). Propensity score matching was then performed for each group to identify 2 matched cohorts. Patients were matched by their primary diagnoses and Model for End‐Stage Liver Disease scores. This resulted in 2 matched cohorts with 55 patients in each group. None of the patients in the APRO group had significant fibrinolysis. In the no‐APRO group, 23.6% of the patients developed fibrinolysis ( P < 0.003). Tranexamic acid was used in 61.5% of the patients (n = 8) in the no‐APRO group in whom lysis was present, and this resolved the fibrinolysis in all but 1 of these patients. There were no differences in red blood cell, fresh frozen plasma, platelet concentrate, or cryoprecipitate transfusions between the 2 groups. In conclusion, we have shown a significant increase in the prevalence of fibrinolysis during OLT since the withdrawal of APRO. However, there has been no increase in transfusion requirements. Liver Transpl 20:584‐590, 2014 . © 2014 AASLD.