Hemodynamics, fluids & transfusion
Incidence of Postreperfusion Hyperfibrinolysis in Liver Transplantation by Donor Type and Observed Treatment Strategies
Authors' conclusion
Anesthesiologists should be aware of the possibility of postreperfusion hyperfibrinolysis in liver transplantation, particularly with DCD donors, and may consider treatment with cryoprecipitate or tranexamic acid.
Study context
- Population
- Patients undergoing liver transplantation at Duke University Hospital, 2015–2020
- Participants
- 535 patients
- Exposure
- Liver donor type: DBD vs DCD vs living donor
- DBDn = 511
- DCDn = 18
- Living donorsn = 6
- Outcome
- Incidence of postreperfusion hyperfibrinolysis
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Hyperfibrinolysis after reperfusion
- Overall incidence of hyperfibrinolysis after reperfusion (21 patients), 95% CI 2.5-5.9
- 3.9%
Observational data: associations, not effects.
Further findings
Treatment and resolution of fibrinolysis
- Cryoprecipitate
- 12/21
- Cryoprecipitate + TXA
- 3/21
- Neither
- 6/21
- Resolved within several hours in all cases
Original publication
Incidence of Postreperfusion Hyperfibrinolysis in Liver Transplantation by Donor Type and Observed Treatment Strategies. Anesth Analg. Published 2 December 2022. doi:10.
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