Perioperative prothrombin complex concentrate and fibrinogen administration are associated with thrombotic complications after liver transplant.
coagulation factors
liver transplant
perioperative coagulation management
postoperative complications
thrombotic complications
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2022
2022
Historique:
received:
13
09
2022
accepted:
09
11
2022
entrez:
16
12
2022
pubmed:
17
12
2022
medline:
17
12
2022
Statut:
epublish
Résumé
Use of intraoperative prothrombin complex concentrates (PCC) and fibrinogen concentrate administration has been linked to thrombotic events. However, it is unknown if its use is associated with thrombotic events after liver transplant. We conducted a Data from 939 transplantations were included in the analysis. Perioperative PCC or fibrinogen administration was independently associated with the primary composite endpoint Hepatic artery thrombosis (HAT), Portal vein thrombosis (PVT), and inferior vena cava thrombosis [adjusted HR: 2.018 (1.174; 3.468), A critical review of established strategies in coagulation management during liver transplantation is warranted. Perioperative caregivers should exercise caution when administering coagulation factor concentrate during liver transplant surgery. Prospective randomized controlled trials are needed to establish causality for the relationship between coagulation factors and thrombotic events in liver transplantation. Further studies should be tailored to identify patient subgroups that will likely benefit from PCC or fibrinogen administration.
Sections du résumé
Background
UNASSIGNED
Use of intraoperative prothrombin complex concentrates (PCC) and fibrinogen concentrate administration has been linked to thrombotic events. However, it is unknown if its use is associated with thrombotic events after liver transplant.
Methods and analysis
UNASSIGNED
We conducted a
Results
UNASSIGNED
Data from 939 transplantations were included in the analysis. Perioperative PCC or fibrinogen administration was independently associated with the primary composite endpoint Hepatic artery thrombosis (HAT), Portal vein thrombosis (PVT), and inferior vena cava thrombosis [adjusted HR: 2.018 (1.174; 3.468),
Conclusion
UNASSIGNED
A critical review of established strategies in coagulation management during liver transplantation is warranted. Perioperative caregivers should exercise caution when administering coagulation factor concentrate during liver transplant surgery. Prospective randomized controlled trials are needed to establish causality for the relationship between coagulation factors and thrombotic events in liver transplantation. Further studies should be tailored to identify patient subgroups that will likely benefit from PCC or fibrinogen administration.
Identifiants
pubmed: 36523786
doi: 10.3389/fmed.2022.1043674
pmc: PMC9745140
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1043674Informations de copyright
Copyright © 2022 Dehne, Riede, Klotz, Sander, Feisst, Merle, Mieth, Golriz, Mehrabi, Büchler, Weigand and Larmann.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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