• Ramona Nicolau-Raducu, Timothy C Ku, Donald R Ganier, Brian M Evans, Joseph Koveleskie, William J Daly, Brian Fish, Ari J Cohen, Trevor W Reichman, Humberto E Bohorquez, David S Bruce, Ian C Carmody, George E Loss, Marina Gitman, Thomas Marshall, and Bobby D Nossaman.
• Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA. Electronic address: rnicolauraducu@ochsner.org.
• J. Cardiothorac. Vasc. Anesth. 2016 Aug 1; 30 (4): 917-23.

ObjectivesTo examine the role of epsilon-aminocaproic acid (EACA) administered after reperfusion of the donor liver in the incidences of thromboembolic events and acute kidney injury within 30 days after orthotopic liver transplantation. One-year survival rates between the EACA-treated and EACA-nontreated groups also were examined.DesignRetrospective, observational, cohort study design.SettingSingle-center, university hospital.ParticipantsThe study included 708 adult liver transplantations performed from 2008 to 2013.InterventionsNone.Measurements And Main ResultsEACA administration was not associated with incidences of intracardiac thrombosis/pulmonary embolism (1.3%) or intraoperative death (0.6%). Logistic regression (n = 708) revealed 2 independent risk factors associated with myocardial ischemia (age and pre-transplant vasopressor use) and 8 risk factors associated with the need for post-transplant dialysis (age, female sex, redo orthotopic liver transplantation, preoperative sodium level, pre-transplant acute kidney injury or dialysis, platelet transfusion, and re-exploration within the first week after transplant); EACA was not identified as a risk factor for either outcome. One-year survival rates were similar between groups: 92% in EACA-treated group versus 93% in the EACA-nontreated group.ConclusionsThe antifibrinolytic, EACA, was not associated with an increased incidence of thromboembolic complications or postoperative acute kidney injury, and it did not alter 1-year survival after liver transplantation.Copyright © 2016 Elsevier Inc. All rights reserved.

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