Transfusion medicine
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Transfusion medicine · Apr 2006
Comparative StudyRecombinant factor VIIa reduces transfusion requirements in liver transplant patients with high MELD scores.
Patients undergoing orthotopic liver transplantation (OLT) often experience significant coagulopathy and remain at risk for excessive blood loss and massive transfusion. The ability of recombinant factor VIIa (rFVIIa) to reduce transfusion requirements during OLT has not been well established. This retrospective study investigates whether rFVIIa reduces transfusion requirements in liver transplant patients with a significantly prolonged prothrombin time (PT) and a model of end-stage liver disease (MELD) score of > 20. ⋯ Hospital stay following transplantation tended to be shorter in the rFVIIa group, albeit statistical significance was not achieved (11 +/- 7.3 versus 7.9 +/- 2.7, P = 0.2). All but one patient in the control group survived for 30 days after transplantation. In a selected group of patients with prolonged PT and high MELD score, the prophylactic application of rFVIIa at the start of the OLT may reduce perioperative transfusion requirements.
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Transfusion medicine · Apr 2006
Clinical TrialSolvent-detergent plasma: use in neonatal patients, in adult and paediatric patients with liver disease and in obstetric and gynaecological emergencies.
The study was conducted to assess the efficacy and tolerance of solvent-detergent (SD) plasma in neonates, in obstetric and gynaecological patients and in patients with liver disease in three large hospitals in Dublin during the period 1 April 2002 (when SD plasma was introduced) through 31 October 2003. Forty-one neonates received 67 transfusions of SD plasma at a mean dose +/- standard deviation of 18.4 +/- 13.2 mL kg(-1). Thirty-one (75.6%) patients had coagulopathy without haemorrhage (either disseminated intravascular coagulopathy or other coagulopathy); a further eight (19.5%) had clinical haemorrhage (excluding intraventricular haemorrhage), which complicated a coagulopathy. ⋯ Complete correction of coagulation parameters was not achieved in any case in the liver transplant group. No adverse reactions were observed for SD plasma infusion. Use of SD plasma in critically ill neonates, in women with obstetric and gynaecological emergencies and in patients with liver disease appears safe, and improves laboratory indices of coagulopathy.