Prothrombin Complex Concentrate Use in Durable and Short-Term Left Ventricular Assist Device Implantation

Abstract

Following Institutional Review Board (IRB) approval, a retrospective chart review of the patients who had undergone LVAD implantation from January 2014 to June 2017 was performed. Adults >18 who had received Profilnine®/Kcentra® for bleeding in the up to 12 hours post-OP were included. Postoperative variables included thrombotic complications e.g. CVA, DVT, PE as well as pump thrombosis. Patient charts were reviewed from admission till 1-year post discharge. Categorical variables were compared with each other using a chi-squared test and continuous variables were compared with the Wilcoxon ranksum test.

Blood product transfusion and lung transplant outcomes: A systematic review

“…To illustrate this point, we did not identify a recent study by Ius et al. that evaluated risk factors for donor specific antibody formation post‐transplant 45 . While RBC transfusion was predictive of DSA formation in a univariate analysis, transfusion did not remain significant in the subsequent multivariate analysis.…”

“…(PCCs) have been shown to have similar efficacy to FFP while having an overall volume sparing effect. 45 In lung transplant, a single case series describes the use of PCCs for warfarin reversal in the perioperative period. 46 However, we did not identify any studies describing the use of PCCs or fibrinogen concentrates to reduce transfusion needs or for rescue in cases of diffuse coagulopathy and bleeding.…”

“…confirmed feasibility with no adverse events from the administration of factor 7a for bleeding in the perioperative period after lung transplant, but with no appreciable reduction in transfusion requirements. In the setting of left ventricular assist device implantation, where patients are anticoagulated on warfarin, prothrombin complex concentrates (PCCs) have been shown to have similar efficacy to FFP while having an overall volume sparing effect 45 . In lung transplant, a single case series describes the use of PCCs for warfarin reversal in the perioperative period 46 .…”