دورية أكاديمية
أعرض في EDS

Implementation of a Bleeding Management Algorithm in Liver Transplantation: A Pilot Study.

التفاصيل البيبلوغرافية
العنوان: Implementation of a Bleeding Management Algorithm in Liver Transplantation: A Pilot Study.
المؤلفون: Sarmiento IA; Department of Anesthesiology, Clínica Santa María, Santiago de Chile, Chile., Guzmán MF; Department of Anesthesiology, Universidad de los Andes, Santiago de Chile, Chile., Chapochnick J; Department of Surgery, Clínica Santa María, Santiago de Chile, Chile., Meier J; Department for Anesthesiology and Critical Care, Kepler University Hospital, Johannes Kepler University, Linz, Austria.
المصدر: Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie [Transfus Med Hemother] 2023 Aug 03; Vol. 51 (1), pp. 1-11. Date of Electronic Publication: 2023 Aug 03 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: S. Karger Country of Publication: Switzerland NLM ID: 101176417 Publication Model: eCollection Cited Medium: Print ISSN: 1660-3796 (Print) Linking ISSN: 16603796 NLM ISO Abbreviation: Transfus Med Hemother Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Basel ; New York : S. Karger, c2003-
مستخلص: Objectives: The aims of the study were to compare the consumption of blood products before and after the implementation of a bleeding management algorithm in patients undergoing liver transplantation and to determine the feasibility of a multicentre, randomized study.
Background: Liver transplantation remains the only curative therapy for patients with end-stage liver disease, but it carries a high risk of surgical bleeding.
Materials and Methods: Retrospective study of patients treated before (group 1) and after (group 2) implementation of a haemostatic algorithm guided by viscoelastic testing, including use of lyophilized coagulation factor concentrates ( prothrombin complex and fibrinogen concentrates ). Primary outcome was the number of units of blood products transfused in 24 h after surgery. Secondary outcomes included hospital stay, mortality, and cost.
Results: Data from 30 consecutive patients was analysed; 14 in group 1 and 16 in group 2. Baseline data were similar between groups. Median total blood product consumption 24 h after surgery was 33 U (IQR: 11-57) in group 1 and 1.5 (0-23.5) in group 2 ( p = 0.028). Significantly fewer units of red blood cells, fresh frozen plasma, and cryoprecipitate were transfused in group 2 versus group 1. There was no significant difference in complications, hospital stay, or in-hospital mortality between groups. The cost of haemostatic therapy was non-significantly lower in group 2 versus group 1 (7,400 vs. 15,500 USD; p = 0.454).
Conclusion: The haemostatic management algorithm was associated with a significant reduction in blood product use during 24 h after liver transplantation. This study demonstrated the feasibility and provided a sample size calculation for a larger, randomized study.
Competing Interests: I.A.S. reports personal fees and non-financial support from Octaphama and Werfen, outside the submitted work. M.F.G., J.C., and J.M. have no conflicts of interest to declare.
(© 2023 The Author(s). Published by S. Karger AG, Basel.)
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فهرسة مساهمة: Keywords: Bleeding; Haemostasis; Liver transplant; Viscoelastic testing
تواريخ الأحداث: Date Created: 20240205 Latest Revision: 20240206
رمز التحديث: 20240206
مُعرف محوري في PubMed: PMC10836948
DOI: 10.1159/000530579
PMID: 38314241
قاعدة البيانات: MEDLINE
الوصف
تدمد:1660-3796
DOI:10.1159/000530579