1. Post-operative heparin reduces early venous thrombotic complications after orthotopic paediatric liver transplantation
- Author
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Colombo, Giovanna, Giaccherini, Cinzia, Benzi, Alberto, Ferrari, Floriana, Bonacina, Daniele, Corno, Manuela, Colledan, Michele, Alessio, Maria Grazia, Bonanomi, Ezio, Nacoti, Mirco, Falanga, Anna, Colombo, G, Giaccherini, C, Benzi, A, Ferrari, F, Bonacina, D, Corno, M, Colledan, M, Alessio, M, Bonanomi, E, Nacoti, M, and Falanga, A
- Subjects
Postoperative Complications ,liver transplantation ,children ,Heparin ,Anticoagulants ,Humans ,thrombosi ,Thrombosis ,Child ,Haemostasis and Thrombosis ,Retrospective Studies - Abstract
BACKGROUND: Despite significant improvements in surgical techniques and medical care, thrombotic complications still represent the primary cause of early graft failure and re-transplantation following paediatric liver transplantation. There is still no standardized approach for thrombosis prevention. MATERIALS AND METHODS: The study aimed to evaluate the effectiveness of early intravenous unfractionated heparin started 12 hours postoperatively at 10 UI/kg per hour and used a retrospective "before and after" design to compare the incidence of early thrombotic complications prior to (2002-2010) and after (2011-2016) the introduction of heparin in our institute. RESULTS: From 2002 to 2016, 479 paediatric patients received liver transplantation in our institution with an overall survival rate over one year of 0.91 (95% CI: 0.87-0.94). Of 365 eligible patients, 244 did not receive heparin while 121 did receive heparin. We reported a lower incidence of venous thrombosis (VT) in the group treated with heparin: 2.5% (3/121) vs 7.9% (19/244) (p=0.038). All clinical and laboratory variables considered potential risk factors for VT were studied. By multivariate stepwise Cox proportional hazards models, heparin prophylaxis resulted significantly associated to a reduction in VT (HR=0.29 [95% CI: 0.08-0.97], p=0.045), while age
- Published
- 2021