Tranexamic acid reduces red cell transfusion better than ε-aminocaproic acid or placebo in liver transplantation
Tranexamic acid reduces red cell transfusion better than ε-aminocaproic acid or placebo in liver transplantation
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DOI：
10.1097/00000539-200007000-00006
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发表时间：
2000-07-01
影响因子：
5.7
通讯作者：
Parrilla, P
中科院分区：
文献类型：
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作者：
Dalmau, A;Sabaté, A;Parrilla, P
我们在一项对 132 名连续患者进行的前瞻性双盲研究中，评估了预防性施用 ε-氨基己酸和氨甲环酸对于减少原位肝移植 (OLT) 中血液制品需求的功效。患者被随机分为三组，并预防性服用三种药物中的一种：氨甲环酸，10 mg。千克（-1）。 h(-1); ε-氨基己酸，16 mg。千克（-1）。 h(-1) 和安慰剂（等渗盐水）。围手术期管理标准化。在 OLT 期间和最初 24 小时内记录凝血测试、血栓弹力图和血液需求量。各组之间的诊断、Child 评分或术前凝血测试没有差异。在OLT期间，氨甲环酸组中浓缩红细胞的施用量显着减少（P=0.023），但ε-氨基己酸组中没有。 There were no differences in transfusion requirements after OLT.三组的血栓栓塞事件、再次手术和死亡率相似。预防性施用氨甲环酸（而非ε-氨基己酸）可显着减少 OLT 期间总红细胞的使用量。
We evaluated the efficacy of the prophylactic administration of epsilon-aminocaproic acid and tranexamic acid for reducing blood product requirements in orthotopic liver transplantation (OLT) in a prospective, double-blinded study performed in 132 consecutive patients. Patients were randomized to three groups and given one of three drugs prophylactically: tranexamic acid, 10 mg . kg(-1) . h(-1); epsilon-aminocaproic acid, 16 mg . kg(-1) . h(-1), and placebo (isotonic saline). Perioperative management was standardized. Coagulation tests, thromboelastogram, and blood requirements were recorded during OLT and in the first 24 h. There were no differences in diagnosis, Child score, or preoperative coagulation tests among groups. Administration of packed red blood cells was significantly reduced (P = 0.023) during OLT in the tranexamic acid group, but not in the epsilon-aminocaproic acid group. There were no differences in transfusion requirements after OLT. Thromboembolic events, reoperations, and mortality were similar in the three groups. Prophylactic administration of tranexamic acid, but not epsilon-aminocaproic acid, significantly reduces total packed red blood cell usage during OLT.