Anesth Analg 2001;93:516
© 2001 International Anesthesia Research Society
LETTERS TO THE EDITOR
Prophylactic use of Tranexamic Acid and Incidence of Arterial Thrombosis in Liver Transplantation
Antonia Dalmau, MD,
Antoni Sabaté, MD,
Maylin Koo, MD,
Antoni Rafecas, MD,
Juan Figueras, MD, and
Eduard Jaurrieta, MD
Departments of Anaesthesiology and Unit of Liver Transplantation, Princeps D’Espanya Hospital, Barcelona, Spain
Departments of Surgery and Unit of Liver Transplantation, Princeps D’Espanya Hospital, Barcelona, Spain
To the Editor:
In a previous controlled study, we found that prophylactic administration of tranexamic acid (TA) 10 mg · kg-1 · h-1 significantly reduced red blood cell transfusion in liver transplantation (1). However, the number of patients evaluated for early (
30 days) arterial thrombosis (EAT) was too small to draw any conclusions. Since that study we have administered prophylactic TA to all patients.
To establish the influence of this treatment on EAT, we studied all consecutive liver transplantations (133 in total) performed from September 1998 to November 2000. Eleven were excluded. EAT was diagnosed by systematic screening of all patients with color pulsed Doppler sonography (128xP/4; Acuson Computed Sonography, Mountain View, CA). Findings were considered abnormal when Doppler signal was absent in either the main hepatic artery or in one of the intrahepatic branches. Arteriography with selective catheterization of the celiac axis was performed in abnormal cases to confirm thrombosis.
Results confirm the reduction of red blood cell transfusion (Table). Rates of EAT (4.9%; confidence interval: 1.1–8.7%) and retrans-plantation (2.5%; confidence interval: 0–5.3%) were comparable to our previous study and to other reports (2 3). We conclude that administration of tranexamic acid does not increase the risk of hepatic arterial thrombosis in liver transplantation.
References
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Dalmau A, Sabaté A, Acosta F, et al. Tranexamic acid reduces red cell transfusion better than epsilon-aminocaproic acid or placebo in liver transplantation. Anesth Analg 2000; 91: 29–34.[Abstract/Free Full Text]
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Parera A, Salcedo M, Vaquero J, et al. Estudio comparativo de las complicaciones arteriales precoces y tardias postransplante hepático. Gastroenterol Hepatol 1999; 22: 381–5.[Medline]
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Pinna AD, Craig VS, Furukawa H, et al. Urgent revascularization of liver allografts after early hepatic artery thrombosis. Transplantation 1996; 62: 1584–7.[ISI][Medline]
