[Reduction of blood loss in orthotopic liver transplantation with the use of aprotinin].
The impact of aprotinin on blood losses during orthotopic liver transplantation (OLT) has been studied retrospectively.


METHODS
From September 1984 to July 1995, 152 patients underwent 168 OLT in our center. Seventy three patients (group I) received epsilon-aminocaproic acid as an antifibrinolytic agent and 95 patients (group II) received aprotinin.


RESULTS
There was a significant reduction in the mean duration of the surgery (I = 743 +/- 25 min; II = 302 +/- 10 min; p < 0.001) and in the post reperfusion time (I = 282 +/- 13 min; II = 126 +/- 6 min; p < 0.001) in the group II. The need for blood products during the operation was also reduced (blood units; I = 21.7 +/- 2.3 units; II = 4.6 +/- 0.4 units; p < 0.001). There was less infectious and hemorrhagic complications requiring reoperation in group II. We have not seen an increased incidence of thrombotic complications in the patients receiving aprotinin. Other variables such as the use of hemoclips, veno-venous bypass and the type of preservation solution were also considered.


CONCLUSIONS
Aprotinin use during OLT is efficient and superior to epsilon-aminocaproic acid in reducing blood losses. Combined with the non-utilisation of a veno-venous by-pass and the use of hemoclips, it helps reduce the operating time and the postoperative complications.
Légaré
G
G
Service de Chirurgie Hépatobiliaíre et Pancréatique, Hôpital Saint-Luc, Université de Montréal, Québec, Canada.
Roy
A
A
Dagenais
M
M
Lapointe
R
R
Marleau
D
D
Thuot
C
C
D000328:Adult; D007611:Aprotinin / Q000008:administration & dosage*; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D003404:Creatinine / Q000097:blood; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007430:Intraoperative Care; D007902:Length of Stay; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D006490:Hemostatics; D007611:Aprotinin; D003404:Creatinine