Is there a procoagulant state long-term after lung transplantation? A prospective study
Is there a procoagulant state long-term after lung transplantation? A prospective study
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DOI：
10.1016/j.rmed.2021.106584
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发表时间：
2021-09-01
影响因子：
4.3
通讯作者：
Roman, Antonio
中科院分区：
文献类型：
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作者：
Saez-Gimenez, Berta;Clofent, David;Roman, Antonio
背景：静脉血栓栓塞症(VTE)是肺移植术后的主要并发症。目的：本研究的目的是纵向评价肝移植术后的凝血状态。方法：对48例患者在肝移植前、术后24~72h、2周、4个月和1年的凝血情况进行前瞻性研究。结果：基线时，除FVIII高于正常范围外，几乎所有分析的凝血因子均在正常范围内。血管性假血友病因子(VWF)和FVIII在移植后明显升高，移植后1年仍维持在较高水平。VTE累积发生率为22.9%。发生VTE的患者在肝移植后2周有较高的FVIII活性。结论：这是第一项描述肝移植后1年内凝血谱的研究。我们发现大多数促凝血状态的标记物在肝移植后2周恢复正常，但FVIII和vWF的值在术后1年仍然异常。这个问题在文献中很少受到关注。有必要进行更大规模的研究，以确认结果并设计适当的预防策略。
Background: Venous thromboembolism (VTE) is a major complication after lung transplantation (LT). However, its pathophysiology remains unknown, and coagulation profiles have yet to be described.Objective: The aim of this study was to longitudinally assess coagulation status after LT.Methods: We performed a prospective study and described the coagulation profiles of 48 patients at 5 different time-points: before LT and at 24-72 h, 2 weeks, 4 months, and 1 year after LT. Results: At baseline, almost all analyzed coagulation factors were within the normal range, except for FVIII, which was above the normal range. Von Willebrand factor (vWF) and FVIII were increased after LT and remained high at 1 year after transplantation. The cumulative incidence of VTE was 22.9%. Patients who developed VTE had higher FVIII activity 2 weeks after LT.Conclusions: This is the first study to describe coagulation profiles up to 1 year after LT. We show that most markers of a procoagulant state normalize at 2 weeks after LT, but that values of FVIII and vWF remain abnormal at 1 year. This problem has received little attention in the literature. Larger studies are necessary to confirm the results and to design appropriate prophylactic strategies.