Intracardiac thrombosis and pulmonary thromboembolism during liver transplantation: A systematic review and meta-analysis

Kumar, Nicolas; Flores, Antolin; Mitchell, Justin J.; Hussain, Nasir; Kumar, Julia; Wang, Jack; Fitzsimons, Michael G.; Dalia, Adam A.; Essandoh, Michael; Black, Sylvester M.; Schenk, Austin D.; Stein, Erica; Turner, Katja; Sawyer, Tamara R.; Iyer, Manoj H.

doi:10.1016/j.ajt.2023.04.029

Cited by 2 publications

(2 citation statements)

References 87 publications

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“…Among patients receiving heart transplantation, Kantorovich et al 11 found the incidence of thrombosis to be 18% in patients receiving Profilnine SD (Grifols Biologicals Inc, Barcelona, Spain), a factor IX complex that contains factors II, VII, IX, and X. 12-18 Although our study and this effort both used factor IX-based PCCs, our lower rate of thrombosis may be because of the differences in ingredients between factor IX concentrates. Kcentra contains several antithrombotic agents, such as proteins C, protein S, and heparin whereas Profilnine SD does not.…”

Section: Discussionmentioning

confidence: 69%

“…ICT is a rare complication with an incidence ranging between 1.2% and 6.2% during OLT and carrying a 40% risk of mortality. 6 , 16 , 17 In this small set of patients, PCC was used to reverse the severe bleeding after heparin or t-PA were given to treat the ICT and no instances of mortality were encountered. In these cases, the patient suffered no further thrombotic complications after PCC was administered, suggesting this is a viable option to treat the subsequent coagulopathy in high-risk patients and such efforts may prove to be lifesaving.…”

Section: Discussionmentioning

confidence: 99%

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Four-factor Prothrombin Complex Concentrate During Liver Transplantation: A Retrospective Cohort Study

Lee,

Rivero,

Renew

et al. 2024

Transplantation Direct

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Background. Four-factor prothrombin complex concentrate (PCC) is a plasma product that contains factors II, VII, IX, X, protein C, and protein S. PCC can be used off-label to treat coagulopathy during orthotopic liver transplantation (OLT). However, its use comes with safety concerns regarding thrombosis. The purpose of our study is to determine the safety of PCC in OLT. Methods. We conducted a retrospective cohort study of patients who received 4-factor PCC during OLT at our institution from January 1, 2018, to May 1, 2022, with a 1:1 match of 83 patients who received PCC and 83 patients who did not. We evaluated 30-d mortality, 1-y mortality, prevalence of thrombotic complications (portal vein thrombosis, deep venous thrombosis, myocardial infarction, and pulmonary embolus), and postoperative intensive care (ICU) length of stay (LOS). Results. There was no significant difference in 30-d mortality (odds ratio [OR] 5; 95% confidence interval [CI], 0.58-42.8; P = 0.14), 1-y mortality (OR 3; 95% CI, 0.61-14.86; P = 0.18), or ICU LOS (OR –13.8; 95% CI, –39.2 to 11.6; P = 0.29). There was no increased incidence of thrombotic complications among patients receiving PCC 90 d after surgery, including portal vein thrombosis (OR 1.5; 95% CI, 0.42-5.32; P = 0.53), pulmonary embolus (OR 1; 95% CI, 0.14-7.1; P = 0.99), deep venous thrombosis (OR 0.67; 95% CI, 0.11-3.99; P = 0.66), and myocardial infarction (OR 1.67; 95% CI, 0.4-6.97; P = 0.48). Conclusions. Although there was a statistically insignificant increase in mortality after PCC administration during OLT, we did not see a significant increase in perioperative complications, including thrombotic events and increased ICU LOS.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Four-factor Prothrombin Complex Concentrate During Liver Transplantation: A Retrospective Cohort Study

Lee,

Rivero,

Renew

et al. 2024

Transplantation Direct

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Abdominal Organ Transplantation: Noteworthy Literature in 2023

Katayama,

Maffucci,

Domanski

et al. 2024

Semin Cardiothorac Vasc Anesth

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This review highlights noteworthy literature published in 2023 and pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We feature 9 studies from 593 peer-reviewed papers on pancreatic transplantation, 3 from 194 on intestinal transplantation, and 28 from over 4513 on kidney transplantation. The liver transplantation section includes a special focus on 20 studies from 5666 clinical trial publications. We explore a broad range of topics, including donor management, perioperative recipient management, and innovative pharmacologic and mechanical interventions tested for the improvement of patient and graft outcomes and survival.

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Intracardiac thrombosis and pulmonary thromboembolism during liver transplantation: A systematic review and meta-analysis

Cited by 2 publications

References 87 publications

Four-factor Prothrombin Complex Concentrate During Liver Transplantation: A Retrospective Cohort Study

Four-factor Prothrombin Complex Concentrate During Liver Transplantation: A Retrospective Cohort Study

Abdominal Organ Transplantation: Noteworthy Literature in 2023

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