title: Solvent detergent vs. fresh frozen plasma in cirrhotic patients undergoing liver transplant surgery: a prospective randomized control study.
abstract: BACKGROUND
  Although orthotopic liver transplantation (OLT) is nowadays considered standard practice at experienced centres, it can still be affected by a significant risk of massive bleeding and its related complications. Solvent/detergent plasma (S/D Plasma) has been proposed as an alternative to fresh frozen plasma (FFP) to curtail such complications. This study aimed at evaluating the efficacy of S/D Plasma in OLT patients by comparing it to FFP.
  
  
  METHODS
  Sixty-three OLT patients were randomized into two groups depending on whether they were transfused with FFP or S/D plasma. A thromboelastography-based protocol aimed at achieving and maintaining predetermined coagulation goals was used to guide plasma transfusions. At the beginning and the end of surgery, standard laboratory coagulation tests were performed together with the assessment of the VII, VIII, V, XII factors and S protein blood levels.
  
  
  RESULTS
  The two study groups equally achieved the thromboelastography goals but with a reduced amount of transfusions in the S/D plasma group (P < 0.0001). At the end of surgery, factors V and XII and S protein blood levels were lower in the S/D plasma patients who also showed lower INR, aPTT and antithrombin III levels.
  
  
  CONCLUSIONS
  In cirrhotic patients undergoing OLT, the use of S\D plasma associated with thromboelastography allows the same clinical results but with a significant reduction in the amount of plasma transfusions.
authors: Liver Transplant Anaesthesia and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. l.bindi@ao-pisa.toscana.it
authors: M L
authors: ML
authors: Bindi
authors: M
authors: M
authors: Miccoli
authors: M
authors: M
authors: Marietta
authors: L
authors: L
authors: Meacci
authors: M
authors: M
authors: Esposito
authors: M
authors: M
authors: Bisà
authors: R
authors: R
authors: Mozzo
authors: A
authors: A
authors: Mazzoni
authors: A
authors: A
authors: Baggiani
authors: F
authors: F
authors: Scatena
authors: F
authors: F
authors: Filipponi
authors: G
authors: G
authors: Biancofiore
mesh_terms: D000328:Adult; D064591:Allografts; D016913:Blood Component Transfusion; D001798:Blood Proteins / Q000378:metabolism; D003902:Detergents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010949:Plasma; D012997:Solvents / Q000008:administration & dosage*; D013916:Thrombelastography / Q000379:methods
chemical_list: D001798:Blood Proteins; D003902:Detergents; D012997:Solvents
keywords: blood transfusion; liver transplantation; thromboelastography