Mediators of fibrinolysis in orthotopic liver transplantation.
Activation of fibrinolysis remains a clinical problem in orthotopic liver transplantation. We have measured tissue plasminogen activator (t-PA), plasmin and alpha-2-anti-plasmin (alpha 2AP) activities in plasma from 10 patients undergoing elective transplantation. t-PA activity increased during the anhepatic phase and immediately after graft reperfusion (p > 0.001). This increase could not be attributed to t-PA released by the donor liver. Overall transfusion requirements did not relate with either t-PA or alpha 2AP activities individually, but were strongly correlated with the ratio t-PA/ alpha 2AP (p > 0.02). These results suggest that routine prophylactic use of antifibrinolytic agents may be beneficial.
Cheema
S P
SP
Department of Anaesthesia, St. James's University Hospital, Leeds, UK.
Webster
N R
NR
Dunn
F
F
Bellamy
M C
MC
D000328:Adult; D000368:Aged; D015209:Cholangitis, Sclerosing / Q000601:surgery; D005341:Fibrinolysin / Q000032:analysis*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000601:surgery; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation; D008875:Middle Aged; D010959:Tissue Plasminogen Activator / Q000097:blood*; D000979:alpha-2-Antiplasmin / Q000032:analysis*; D000511:alpha-Macroglobulins
D000979:alpha-2-Antiplasmin; D000511:alpha-Macroglobulins; C024668:plasmin-alpha(2)-macroglobulin complex; D010959:Tissue Plasminogen Activator; D005341:Fibrinolysin