14353
document
Different aprotinin applications influencing hemostatic changes in orthotopic liver transplantation . The effect of different aprotinin applications on hemostatic changes and blood product requirements in orthotopic liver transplantation was investigated in a prospective , open , and randomized study . From November 1989 to June 1990 , 13 patients received aprotinin as a bolus of 0.5 Mill . Kallikrein inactivator units ( KIU ) on three occasions in the course of an OLT , whereas 10 other patients were treated with continuous aprotinin infusion of 0.1-0.4 Mill . KIU/hr . Before and after reperfusion of the graft liver , signs of hyperfibrinolysis , measured by thrombelastography , were significantly lower in the infusion group . Tissue-type plasminogen activator ( t-PA ) activity increased during the anhepatic phase but to a significantly lesser extent in the infusion group . Blood product requirements during OLT were tendentiously higher in the bolus group but not significantly so . However , the use of packed red blood cells was significantly lower in the postoperative period , whereas there was no significant difference in fresh frozen plasma requirements between the two groups . All 23 patients have survived , and only one woman of each group required retransplantation due to severe host-versus-graft reactions . Furthermore , we investigated the perfusate of the graft liver in both groups and detected signs of a decreased t-PA release in the infusion group . Our results demonstrate an advantage of aprotinin given as continuous infusion over bolus application in OLT .
14354
Intervention_Pharmacological
Different aprotinin applications
14355
Intervention_Pharmacological
aprotinin applications
14356
Intervention_Pharmacological
aprotinin
14357
Intervention_Pharmacological
bolus of 0.5 Mill
14358
Intervention_Pharmacological
continuous aprotinin infusion of 0.1-0.4 Mill
14359
Intervention_Pharmacological
aprotinin
14360
Outcome_Physical
graft liver , signs of hyperfibrinolysis
14361
Outcome_Physical
Tissue-type plasminogen activator ( t-PA ) activity
14362
Outcome_Physical
Blood product requirements
14363
Outcome_Physical
packed red blood cells
14364
Outcome_Other
plasma requirements
14365
Outcome_Mortality
survived
14366
Outcome_Physical
retransplantation
14367
Outcome_Physical
host-versus-graft reactions
14368
Outcome_Physical
t-PA release
14369
Participant_Condition
orthotopic liver transplantation .
14370
Participant_Sample-size
13
14371
Participant_Sample-size
23