dc.contributor |
Universitat de Barcelona |
dc.contributor.author |
Costa, M. |
dc.contributor.author |
Dalmau Llitjós, Antònia |
dc.contributor.author |
Sabaté Pes, Antoni |
dc.contributor.author |
Koo Gómez, Maylin |
dc.contributor.author |
Aparicio, I |
dc.contributor.author |
Contreras, L. |
dc.date |
2018-01-09T08:24:41Z |
dc.date |
2018-01-09T08:24:41Z |
dc.date |
2014-05 |
dc.date |
2018-01-09T08:24:41Z |
dc.identifier.citation |
0375-9393 |
dc.identifier.citation |
654517 |
dc.identifier.uri |
http://hdl.handle.net/2445/118914 |
dc.format |
6 p. |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
Edizioni Minerva Medica |
dc.relation |
Versió postprint del document publicat a: https://www.minervamedica.it/en/journals/minerva-anestesiologica/article.php?cod=R02Y2014N05A0568 |
dc.relation |
Minerva Anestesiologica, 2014, vol. 80, num. 5, p. 568-573 |
dc.rights |
(c) Edizioni Minerva Medica , 2014 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.subject |
Trasplantament hepàtic |
dc.subject |
Plasma sanguini |
dc.subject |
Coagulació sanguínia |
dc.subject |
Fibrinòlisi |
dc.subject |
Hepatic transplantation |
dc.subject |
Blood plasma |
dc.subject |
Blood coagulation |
dc.subject |
Fibrinolysis |
dc.title |
Low plasma fibrinogen levels and blood product transfusion in liver transplantation |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/acceptedVersion |
dc.description.abstract |
Aim: Risk of bleeding in liver transplantation is determined by surgical technique, preoperative hemoglobin and antifibrinolitic therapy. We hypothesized that keeping these confounders factors identical, preoperative plasma fibrinogen level of ≤2 g/L influenced on blood product requirements. Methods: Adult patients underwent orthotropic liver transplantation (LT) during the period between January 1998 and December 2009. Cases were selected according to a propensity matching analysis meeting the following criteria: surgical vena cava preservation, tranexamic acid administration and hemoglobin range between 90 to 120 g/L. Intraoperative management was protocolized. The main variable was the percentage of patients that did not require red blood cells (RBC's). Results: Six hundred sixty-four patients with LT, 208 excluded, 266 who cannot be matched, the analysis was performed on 190 patients. Two cohorts: Low fibrinogen (≤2 g/L) (61 cases) and standard fibrinogen (>2 g/L) (129 cases) were analyzed. Preoperative platelet count (73.5±52 vs. 104±65; 103/mm3) was different in contrast to the hemoglobin (104.2±8.6 vs. 105.6±8.3; g/L). Use of RBC's resulted significantly higher in the low fibrinogen group (median, 3 vs. 2). The number of patients with no blood product requirements was fewer in the low fibrinogen group (8 cases, 13% vs. 45 cases, 35%). The critical level of plasma fibrinogen (1 g/L) was reached after graft reperfusion in 7 cases (5.5%) in the standard fibrinogen group vs. 24 cases (39%) in the low fibrinogen group. Conclusion: Our data suggest that preoperative plasma fibrinogen level of ≤2 g/L increases requirements for blood products during the surgical procedure of liver transplantation. |