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J Cardiothorac Vasc Anesth ; 30(4): 917-23, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27020101

RESUMEN

OBJECTIVES: 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. DESIGN: Retrospective, observational, cohort study design. SETTING: Single-center, university hospital. PARTICIPANTS: The study included 708 adult liver transplantations performed from 2008 to 2013. INTERVENTIONS: None. MEASUREMENTS AND MAIN 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.


Asunto(s)
Lesión Renal Aguda/etiología , Ácido Aminocaproico/efectos adversos , Antifibrinolíticos/efectos adversos , Trasplante de Hígado/efectos adversos , Tromboembolia/etiología , Ácido Aminocaproico/administración & dosificación , Antifibrinolíticos/administración & dosificación , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Trasplante de Hígado/mortalidad , Masculino , Persona de Mediana Edad , Terapia de Reemplazo Renal , Estudios Retrospectivos , Factores de Riesgo , Análisis de Supervivencia
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