Effects of plasma transfusions on antithrombin levels after paediatric liver transplantation.

Détails

ID Serval
serval:BIB_163175AC9D27
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Effects of plasma transfusions on antithrombin levels after paediatric liver transplantation.
Périodique
Vox sanguinis
Auteur(s)
Arni D., Wildhaber B.E., McLin V., Rimensberger P.C., Ansari M., Fontana P., Karam O.
ISSN
1423-0410 (Electronic)
ISSN-L
0042-9007
Statut éditorial
Publié
Date de publication
15/05/2018
Peer-reviewed
Oui
Numéro
113
Pages
569-576
Langue
anglais
Notes
Publication types: Journal Article

Résumé
Thrombotic complications affect 3-10% of patients after liver transplantation (LT), leading to potentially life-threatening complications. In the days following LT, antithrombin (AT) is decreased longer than pro-coagulant factors, thus favouring a pro-thrombotic profile. Plasma transfusions are given empirically in some centres to correct AT levels following LT. We assessed the effect of plasma transfusion on AT levels after paediatric LT.
Prospective single-centre observational study in 20 consecutive paediatric LT recipients over a 24-month period. Plasma was administered twice daily (10 ml/kg/dose) according to an existing protocol. AT levels were measured once daily, immediately prior to and one hour after the morning plasma transfusion. Sample size was calculated based on a non-inferiority hypothesis.
The median age and weight were 11.6 years (IQR 2.8; 14.7) and 40 kg (IQR 12.75; 44.8), respectively. We collected 85-paired blood samples. The median AT level prior to plasma transfusion was 58%. The median difference in AT levels before and after plasma transfusion was 4.2% (P = 0.001). Changes in AT levels after plasma transfusion were not correlated with baseline AT levels (R = 0.19) or patient weight (R = 0.18).
Plasma transfusions only marginally increase AT levels in children after LT. Therefore, prophylactic plasma transfusions probably do not seem to confer an advantage in the routine management of paediatric LT patients. Randomized controlled trials are needed to identify the optimal anticoagulation strategy in this specific population.
Mots-clé
antithrombin III, blood transfusion, liver transplantation, child, plasma
Pubmed
Web of science
Création de la notice
08/10/2018 9:10
Dernière modification de la notice
19/12/2019 16:56
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