Fibrinolysis resistance after liver transplant as a predictor of early infection - 08/12/22
Abstract |
Background |
Infection is a leading cause of morbidity in liver transplant (LT). Considering that the fibrinolytic system is altered in sepsis, we investigated the relationship between fibrinolysis resistance (FR) and post-transplant infection.
Methods |
Fibrinolysis was quantified using thrombelastography (TEG) with the addition of tPA to quantify FR. FR was defined as LY30 = 0% and stratified as transient if present on POD1 or POD5 (tFR), persistent (pFR) if present on both, or no FR (nFR) if absent.
Results |
180 LT recipients were prospectively enrolled. 52 (29%) recipients developed infection. 72 had tFR; 37 had pFR; and 71 had nFR. Recipients with pFR had significantly greater incidence of infections (51% vs. 26% tFR vs. 20% nFR, p = 0.002). pFR was independently associated with increased odds of post-transplant infection (adjusted OR 3.39, p = 0.009).
Conclusions |
Persistent fibrinolysis resistance is associated with increased risk of post-transplant infection.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Single-center prospective study with 180 liver transplant recipients. |
• | Thrombelastography (TEG) with exogenous tPA used to quantify fibrinolysis activity. |
• | Serial TEGs performed on postoperative days 1 and 5. |
• | Fibrinolysis resistance is linked to an increased risk of posttransplant infection. |
Keywords : Fibrinolysis resistance, Thrombelastography (TEG), Plasminogen activator inhibitor 1 (PAI-1), Liver transplant, Infection
Plan
☆ | This study was supported in part by National Heart Lung and Blood Institute: R00-HL151887, The American Society of Transplant Surgeons Veloxis Fellowship Award, and The University of Colorado's Academic Enrichment Fund. |
Vol 224 - N° 6
P. 1455-1459 - décembre 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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