title: Epsilon-Aminocaproic Acid Has No Association With Thromboembolic Complications, Renal Failure, or Mortality After Liver Transplantation.
abstract: OBJECTIVE
  To examine the role of epsilon-aminocaproic acid (EACA) administered after reperfusion of the donor liver in the incidences of thromboembolic events and acute kidney injury within 30 days after orthotopic liver transplantation. One-year survival rates between the EACA-treated and EACA-nontreated groups also were examined.
  
  
  METHODS
  Retrospective, observational, cohort study design.
  
  
  METHODS
  Single-center, university hospital.
  
  
  METHODS
  The study included 708 adult liver transplantations performed from 2008 to 2013.
  
  
  METHODS
  None.
  
  
  RESULTS
  EACA administration was not associated with incidences of intracardiac thrombosis/pulmonary embolism (1.3%) or intraoperative death (0.6%). Logistic regression (n = 708) revealed 2 independent risk factors associated with myocardial ischemia (age and pre-transplant vasopressor use) and 8 risk factors associated with the need for post-transplant dialysis (age, female sex, redo orthotopic liver transplantation, preoperative sodium level, pre-transplant acute kidney injury or dialysis, platelet transfusion, and re-exploration within the first week after transplant); EACA was not identified as a risk factor for either outcome. One-year survival rates were similar between groups: 92% in EACA-treated group versus 93% in the EACA-nontreated group.
  
  
  CONCLUSIONS
  The antifibrinolytic, EACA, was not associated with an increased incidence of thromboembolic complications or postoperative acute kidney injury, and it did not alter 1-year survival after liver transplantation.
authors.affiliation: Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA. Electronic address: rnicolauraducu@ochsner.org.
authors.forename: Ramona
authors.initials: R
authors.lastname: Nicolau-Raducu
authors.affiliation: Department of Anesthesiology, Tulane Medical Center, New Orleans, LA.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Ku
authors.affiliation: Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Ganier
authors.affiliation: Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Evans
authors.affiliation: Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Koveleskie
authors.affiliation: Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Daly
authors.affiliation: Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Brian
authors.initials: B
authors.lastname: Fish
authors.affiliation: Department of Surgery/Transplantation, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Ari J
authors.initials: AJ
authors.lastname: Cohen
authors.affiliation: Department of Surgery/Transplantation, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Reichman
authors.affiliation: Department of Surgery/Transplantation, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Humberto E
authors.initials: HE
authors.lastname: Bohorquez
authors.affiliation: Department of Surgery/Transplantation, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: David S
authors.initials: DS
authors.lastname: Bruce
authors.affiliation: Department of Surgery/Transplantation, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Ian C
authors.initials: IC
authors.lastname: Carmody
authors.affiliation: Department of Surgery/Transplantation, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: George E
authors.initials: GE
authors.lastname: Loss
authors.affiliation: Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL.
authors.forename: Marina
authors.initials: M
authors.lastname: Gitman
authors.affiliation: Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Marshall
authors.affiliation: Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Bobby D
authors.initials: BD
authors.lastname: Nossaman
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D015119:Aminocaproic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013923:Thromboembolism / Q000209:etiology*
chemical_list: D000933:Antifibrinolytic Agents; D015119:Aminocaproic Acid
keywords: acute kidney injury; antifibrinolytics; epsilon-aminocaproic acid; intracardiac thrombosis/pulmonary embolism; liver transplantation; thromboembolic complications