Aprotinin in orthotopic liver transplantation (OLT) : Clinical and economical interest in blood requirements

Lassale, B.; Rathelot, P.; Angelini, B.; Bongrand, M.C.; Timon-David, P.

Journal de Pharmacie Clinique 15(3): 187-191

1996


ISSN/ISBN: 0291-1981
Accession: 008184267

Download citation:  
Text
  |  
BibTeX
  |  
RIS

Article/Abstract emailed within 1 workday
Payments are secure & encrypted
Powered by Stripe
Powered by PayPal

Abstract
In order to reduce blood loss and homologous transfusions in orthotopic liver transplantation (OLT), the medical team have been associated with the intra-operative autologous blood transfusion to their surgical procedure since 1988. Then the patients have been given an antifibrinolytic drug: aprotinin. The administration of that drug at high doses may result in thrombotic events. Therefore, we compared the effect of low (100,000 KIU/hour) and high doses (leading dose of 2,000,000 KIU/hour after anesthesia induction, followed by a continuous infusion of 500,000 KIU/hour until the end of procedure of aprotinin (Antagosan) when combined with intra-operative blood salvage during OLT. The economic consequence of intra-operative autologous blood transfusion was similar in both groups of patients and made it possible to reach a 25% decrease of the expenses in pocked red blood cells (RBCs). Compared with the low dosage regimen, the administration of Antagosan at high doses resulted in a reduction of blood requirements in RBCs (p = 0.01) and fresh frozen plasma (FFP) (p = 0.01). No thrombotic event was noticed in either group. A total average saving of 2,883 F per patient on the transfusion-related-expenses (32%) was achieved thanks to this reduction of homologous blood transfusion. The obvious clinical interest and cost-effectiveness value of the aprotinin when administered at high doses in OLT couldn't be denied. Therefore this dosage regimen has been adopted.