title: Thrombin-activatable Fibrinolysis Inhibitor (TAFI) as a Novel Prognostic Factor After Orthotropic Liver Transplantation: A Pilot Study.
abstract: BACKGROUND
  Thrombin-activatable fibrinolysis inhibitor (TAFI), a liver-produced coagulation factor, has been associated with higher mortality in cirrhotic patients, but there has not been any description of its role in perioperative care in liver transplantation cases.
  
  
  METHODS
  A total of 21 patients were included. Serum TAFI levels were determined at 3 time points: preoperatively (TAFI pre), immediately postoperative (TAFI PO), and 24 hours postoperatively (TAFI 24 h). The main outcome was the physiological pattern of TAFI in the perioperative period of liver transplantation. The secondary outcomes were the association between TAFI and early allograft dysfunction (EAD) as well as that of TAFI and 6-month mortality.
  
  
  RESULTS
  TAFI levels increased at the 24-hour time point, compared to the other 2 time points (TAFI pre, P = .007; TAFI PO, P = .0001). Early allograft dysfunction occurred in 2 of 21 patients, both demonstrating lower TAFI 24 h levels compared to those who did not develop this complication (3.0 ± 0.2 vs 1.5 ± 0.3; P = .0001). Three patients who died all demonstrated lower levels of TAFI pre (1.3 ± 0.1 vs 2.5 ± 0.5; P = .001) and TAFI PO (1.2 ± 0.1 vs 2.4 ± 0.4; P = .001) compared to the survivors.
  
  
  CONCLUSIONS
  These findings suggest that the determination of TAFI levels-both pre- and postoperatively-may be of clinical relevance in liver transplant recipients.
authors: Postgraduation Program in Hepatology, Universidade Federal de Ciências da Saúde, Porto Alegre, Brazil. Electronic address: wagnernedel@uol.com.br.
authors: W L
authors: WL
authors: Nedel
authors: Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
authors: E M
authors: EM
authors: Rodrigues Filho
authors: Postgraduation Program in Hepatology, Universidade Federal de Ciências da Saúde, Porto Alegre, Brazil; Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
authors: A C
authors: AC
authors: Pasqualotto
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D025901:Carboxypeptidase B2 / Q000378:metabolism*; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000378:metabolism; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis
chemical_list: D015415:Biomarkers; C585364:CPB2 protein, human; D025901:Carboxypeptidase B2