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Aprotinin reduces red blood cell transfusion in orthotopic liver transplantation: A prospective, randomized, double‐blind study
Author(s) -
Findlay James Y.,
Rettke Steven R.,
Ereth Mark H.,
Plevak David J.,
Krom Ruud A.F.,
Kufner Ronald P.
Publication year - 2001
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 - 10.1053/jlts.2001.27086
Subject(s) - medicine , aprotinin , thromboelastography , blood product , anesthesia , interquartile range , blood transfusion , surgery , liver transplantation , packed red blood cells , red blood cell , transplantation , coagulation
The effect of an aprotinin infusion on blood and blood product transfusion during adult primary orthotopic liver transplantation (OLT) was investigated in a prospective, randomized, double‐blind study. Sixty‐three patients were enrolled; 33 patients were administered an aprotinin regimen of a 1,000,000‐KIU loading dose, followed by a 250,000‐KIU/h infusion during surgery, and 30 patients were administered equivalent volumes of normal saline. Red blood cell (RBC) and blood product transfusion intraoperatively and for the first 24 hours postoperatively was by protocol. Intraoperative coagulation testing and thromboelastography (TEG; Hemoscope Corp, Skokie, IL) were performed. Intraoperative RBC transfusion was significantly less in the aprotinin group versus controls: median, 5 units (interquartile range [IQR], 3 to 9 units) versus 7 units (IQR, 5 to 16 units; P = .0016). No significant differences were found for intraoperative blood product transfusion or transfusion of RBCs or blood products in the 24‐hour postoperative period. No significant differences were observed in intraoperative coagulation testing or TEG parameters. We conclude that aprotinin infusion reduces RBC transfusion requirements in OLT.