Abstract
Background Liver transplantation regularly implies transfusion of red blood cells (RBC), plasma, and platelets. Compared to fresh frozen plasma (FFP) from single blood donors, solvent/detergent treated plasma (SD-plasma) pooled from several hundred blood donors has advantages with respect to pathogen reduction, standardized content of plasma proteins, and significantly reduced risk of transfusion related lung injury and allergic/immunologic adverse reactions. However, SD-plasma has been suspected to increase the incidence of hyperfibrinolysis and thromboembolic events.
Study design and Methods We investigated the transfusion practices, hyperfibrinolysis parameters, and thrombosis outcomes in 195 adult consecutive primary liver transplants in our center using SD-plasma (Octaplas®) as the exclusive source of plasma.
Results Perioperatively, median (interquartile range) 4 (1–9) RBC-units, 10 (4–18) plasma-bags, and 0 (0–2) platelet-units were transfused. Hyperfibrinolysis defined as LY30 ≥ 7.5 % was detected in 12/138 thrombelastography-monitored patients (9 %). These patients received significantly more RBCs, plasma, and platelets than did patients without hyperfibrinolysis. Thrombotic graft complications were observed in three patients (2 %). Pulmonary embolism was not observed in any patient.
Conclusion SD-plasma is a safe plasma product for liver transplant recipients, and the incidences of hyperfibrinolysis and thromboembolic events are not significantly different from those seen in centers using FFP.
- Received April 12, 2013.
- Revision received July 28, 2013.
- Accepted September 11, 2013.
