Fibrinolysis resistance after liver transplant as a predictor of early infection - 08/12/22
, Dor Yoeli a, Tanner Ferrell a, Jessie G. Jiang b, Ronald Truong b, Trevor L. Nydam a, Megan A. Adams c, J. Michael Cullen a, Elizabeth A. Pomfret a, Hunter B. Moore aAbstract |
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 numéro
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