title: Coagulation changes and the influence of the early perfusate in the course of orthotopic liver transplantation (OLT) when aprotinin is used intra-operatively.
abstract: The changes in relevant haemostatic parameters during the course of ten orthotopic liver transplantation were studied when aprotinin was given intra-operatively. Increases of tissue-type (P = 0.008) and urokinase-type (P = 0.009) plasminogen activators during the anhepatic phase could be correlated with hyperfibrinolysis. Thrombin-antithrombin III complexes (TAT) increased after revascularization of the liver graft (P = 0.003). Parallel studies in the perfusate showed that TAT concentrations were 350% and protease inhibitor activities (antithrombin III, protein C) only 52% of the systemic circulation before reperfusion, suggesting that thrombin activation together with protease inhibitor consumption occurs during graft liver reperfusion. The relatively smaller increases in profibrinolytic parameters and a lower blood loss when compared with other groups may be explained by aprotinin administration in our patients.
authors.affiliation: Department of Internal Medicine, Universitätsklinikum Rudolf Virchow, Berlin, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Himmelreich
authors.forename: B
authors.initials: B
authors.lastname: Kierzek
authors.forename: P
authors.initials: P
authors.lastname: Neuhaus
authors.forename: K J
authors.initials: KJ
authors.lastname: Slamer
authors.forename: M
authors.initials: M
authors.lastname: Jochum
authors.forename: H
authors.initials: H
authors.lastname: Riess
mesh_terms: D000990:Antithrombin III / Q000032:analysis; D007611:Aprotinin / Q000627:therapeutic use*; D001778:Blood Coagulation Disorders / Q000188:drug therapy / Q000209:etiology*; D016063:Blood Loss, Surgical; D005340:Fibrinogen / Q000032:analysis; D005342:Fibrinolysis; D006801:Humans; D007430:Intraoperative Care; D016031:Liver Transplantation / Q000009:adverse effects*; D010447:Peptide Hydrolases / Q000032:analysis; D010477:Perfusion; D010960:Plasminogen Activators / Q000032:analysis; D011486:Protein C / Q000032:analysis; D015424:Reperfusion
chemical_list: D011486:Protein C; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D005340:Fibrinogen; D007611:Aprotinin; D010447:Peptide Hydrolases; D010960:Plasminogen Activators