Academic Journal
Routine Postoperative Antithrombotic Therapy in Pediatric Liver Transplantation:Impact on Bleeding and Thrombotic Complications
| العنوان: | Routine Postoperative Antithrombotic Therapy in Pediatric Liver Transplantation:Impact on Bleeding and Thrombotic Complications |
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| المؤلفون: | Werner, Maureen J M, de Kleine, Ruben H J, de Boer, Marieke T, de Meijer, Vincent E, Scheenstra, René, Verkade, Henkjan J, Bodewes, Frank A J A, Bontemps, Sander T H, Reyntjens, Koen M E M, Dikkers, Riksta, Lisman, Ton, Porte, Robert J |
| المصدر: | Werner , M J M , de Kleine , R H J , de Boer , M T , de Meijer , V E , Scheenstra , R , Verkade , H J , Bodewes , F A J A , Bontemps , S T H , Reyntjens , K M E M , Dikkers , R , Lisman , T & Porte , R J 2020 , ' Routine Postoperative Antithrombotic Therapy in Pediatric Liver Transplantation : Impact on Bleeding and Thrombotic Complications ' , Thrombosis and Haemostasis , vol. 120 , no. 4 , pp. 627-637 . .... |
| سنة النشر: | 2020 |
| المجموعة: | University of Groningen research database |
| مصطلحات موضوعية: | antithrombotic therapy, pediatric liver transplantation, bleeding, thrombosis, HEPATIC-ARTERY THROMBOSIS, VASCULAR COMPLICATIONS, COAGULATION SYSTEM, CHILDREN, MANAGEMENT, PROGRESS |
| الوصف: | BACKGROUND: Hepatic artery thrombosis (HAT) and portal vein thrombosis (PVT) are serious causes of morbidity and mortality after pediatric liver transplantation. To reduce thrombotic complications, routine antithrombotic therapy consisting of 1 week heparin followed by 3 months acetylsalicylic acid, was implemented in our pediatric liver transplant program in 2003. This study aimed to evaluate incidences of bleeding and thrombotic complications since the implementation of routine antithrombotic therapy and to identify risk factors for these complications. METHODS: This retrospective cohort study includes 200 consecutive pediatric primary liver transplantations performed between 2003 and 2016. Uni- and multivariate logistic regression analysis, Kaplan-Meier method, and Cox regression analysis were used to evaluate recipient outcome. RESULTS: HAT occurred in 15 (7.5%), PVT in 4 (2.0%), and venous outflow tract thrombosis in 2 (1.0%) recipients. Intraoperative vascular interventions (odds ratio [OR] 14.45 [95% confidence interval [CI] 3.75-55.67]), low recipient age (OR 0.81 [0.69-0.95]), and donor age (OR 0.96 [0.93-0.99]) were associated with posttransplant thrombosis. Clinically relevant bleeding occurred in 37%. Risk factors were high recipient age (OR 1.08 [1.02-1.15]), high Child-Pugh scores (OR 1.14 [1.02-1.28]), and intraoperative blood loss in mL/kg (OR 1.003 [1.001-1.006]). Both posttransplant thrombotic (hazard ratio [HR] 3.38 [1.36-8.45]; p = 0.009) and bleeding complications (HR 2.50 [1.19-5.24]; p = 0.015) significantly increased mortality. CONCLUSION: In 200 consecutive pediatric liver transplant recipients receiving routine postoperative antithrombotic therapy, we report low incidences of posttransplant vascular complications. Posttransplant antithrombotic therapy seems to be a valuable strategy in pediatric liver transplantation. Identified risk factors for bleeding and thrombotic complications might facilitate a more personalized approach in antithrombotic therapy. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| DOI: | 10.1055/s-0039-1701010 |
| الاتاحة: | https://hdl.handle.net/11370/43923d62-117b-4063-a2fb-1d5d42d5bc2a https://research.rug.nl/en/publications/43923d62-117b-4063-a2fb-1d5d42d5bc2a https://doi.org/10.1055/s-0039-1701010 https://pure.rug.nl/ws/files/121076612/s_0039_1701010.pdf |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.14F1A4AE |
| قاعدة البيانات: | BASE |
| DOI: | 10.1055/s-0039-1701010 |
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