Is there a procoagulant state long-term after lung transplantation? A prospective study.


Journal

Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438

Informations de publication

Date de publication:
11 2021
Historique:
received: 26 02 2021
revised: 18 08 2021
accepted: 22 08 2021
pubmed: 25 9 2021
medline: 8 2 2022
entrez: 24 9 2021
Statut: ppublish

Résumé

Venous thromboembolism (VTE) is a major complication after lung transplantation (LT). However, its pathophysiology remains unknown, and coagulation profiles have yet to be described. The aim of this study was to longitudinally assess coagulation status after LT. We performed a prospective study and described the coagulation profiles of 48 patients at 5 different time-points: before LT and at 24-72 h, 2 weeks, 4 months, and 1 year after LT. At baseline, almost all analyzed coagulation factors were within the normal range, except for FVIII, which was above the normal range. Von Willebrand factor (vWF) and FVIII were increased after LT and remained high at 1 year after transplantation. The cumulative incidence of VTE was 22.9%. Patients who developed VTE had higher FVIII activity 2 weeks after LT. This is the first study to describe coagulation profiles up to 1 year after LT. We show that most markers of a procoagulant state normalize at 2 weeks after LT, but that values of FVIII and vWF remain abnormal at 1 year. This problem has received little attention in the literature. Larger studies are necessary to confirm the results and to design appropriate prophylactic strategies.

Sections du résumé

BACKGROUND
Venous thromboembolism (VTE) is a major complication after lung transplantation (LT). However, its pathophysiology remains unknown, and coagulation profiles have yet to be described.
OBJECTIVE
The aim of this study was to longitudinally assess coagulation status after LT.
METHODS
We performed a prospective study and described the coagulation profiles of 48 patients at 5 different time-points: before LT and at 24-72 h, 2 weeks, 4 months, and 1 year after LT.
RESULTS
At baseline, almost all analyzed coagulation factors were within the normal range, except for FVIII, which was above the normal range. Von Willebrand factor (vWF) and FVIII were increased after LT and remained high at 1 year after transplantation. The cumulative incidence of VTE was 22.9%. Patients who developed VTE had higher FVIII activity 2 weeks after LT.
CONCLUSIONS
This is the first study to describe coagulation profiles up to 1 year after LT. We show that most markers of a procoagulant state normalize at 2 weeks after LT, but that values of FVIII and vWF remain abnormal at 1 year. This problem has received little attention in the literature. Larger studies are necessary to confirm the results and to design appropriate prophylactic strategies.

Identifiants

pubmed: 34560353
pii: S0954-6111(21)00291-2
doi: 10.1016/j.rmed.2021.106584
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

106584

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Auteurs

Berta Sáez-Giménez (B)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain.

David Clofent (D)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain.

Manuel López Meseguer (M)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: manuelop@vhebron.net.

Carlos Bravo Masgoret (C)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.

Victor Monforte (V)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.

Cristina Berastegui (C)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain.

Eva Revilla-Lopez (E)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain.

Miriam Barrecheguren (M)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain.

Marta Arjona-Peris (M)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain.

Victoria Ruiz (V)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain.

Maria Antonia Ramon (MA)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.

Susana Gómez-Ollés (S)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.

Amparo Santamaría (A)

Hemostasis and Thrombosis Unit, Department of Hematology, Hospital Univeristari Vall D'Hebrón, Barcelona, Spain.

Antonio Roman (A)

Pulmonology Service, Lung Transplant Program, Hospital Universitari Vall D'Hebrón. Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.

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Classifications MeSH