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Utility of prothrombin complex concentrate as first‐line treatment modality of coagulopathy in patients undergoing liver transplantation: A propensity score‐matched study
Author(s) -
Srivastava Piyush,
Agarwal Anil,
Jha Amit,
Rodricks Suvyl,
Malik Tanuja,
Makki Kausar,
Singhal Ashish,
Vij Vivek
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13435
Subject(s) - medicine , propensity score matching , prothrombin complex concentrate , coagulopathy , fresh frozen plasma , liver transplantation , retrospective cohort study , surgery , blood transfusion , transplantation , complication , packed red blood cells , prothrombin complex , anesthesia , platelet , coagulation , warfarin , atrial fibrillation
Abstract Background Transfusion management during liver transplantation (LT) is aimed at reducing blood loss and allogeneic transfusion requirements. Although prothrombin complex concentrate (PCC) has been used satisfactorily in various bleeding disorders, studies on its safety, and efficacy during LT are limited. Methods A retrospective chart review of adult patients who underwent living donor LT at a single institute between October 2016 and January 2018 was carried out. The safety and efficacy of PCC in reducing transfusion requirements intraoperatively in patients who received PCC were compared with patients who did not receive PCC. A propensity score‐matching technique was used, at a 1:1 ratio, to remove selection bias. Results After completing the 1:1 propensity score‐matched analysis, 60 pairs of patients were identified. The use of PCC was associated with significantly decreased red blood cell transfusion requirements (6.2 ± 4.1 vs 8.23 ± 5.18, P < 0.001) and fresh frozen plasma transfusion requirements (2.6 ± 2 vs 6.18 ± 4.1, P < 0.001). The number of patients developing postoperative hemorrhagic complications was higher in the non‐PCC group. Conclusions During LT, the use of PCC led to decreased transfusion requirements. No thromboembolic complications related to PCC were noted in this series.