Highlights
- •Single-center prospective study with 180 liver transplant recipients.
- •Thrombelastography (TEG) with exogenous tPA used to quantify fibrinolysis activity.
- •Serial TEGs performed on postoperative days 1 and 5.
- •Fibrinolysis resistance is linked to an increased risk of posttransplant infection.
Abstract
Background
Infection is a leading cause of morbidity in liver transplant (LT). Considering that
the fibrinolytic system is altered in sepsis, we investigated the relationship between
fibrinolysis resistance (FR) and post-transplant infection.
Methods
Fibrinolysis was quantified using thrombelastography (TEG) with the addition of tPA
to quantify FR. FR was defined as LY30 = 0% and stratified as transient if present
on POD1 or POD5 (tFR), persistent (pFR) if present on both, or no FR (nFR) if absent.
Results
180 LT recipients were prospectively enrolled. 52 (29%) recipients developed infection.
72 had tFR; 37 had pFR; and 71 had nFR. Recipients with pFR had significantly greater
incidence of infections (51% vs. 26% tFR vs. 20% nFR, p = 0.002). pFR was independently
associated with increased odds of post-transplant infection (adjusted OR 3.39, p = 0.009).
Conclusions
Persistent fibrinolysis resistance is associated with increased risk of post-transplant
infection.
Keywords
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Article info
Publication history
Published online: September 13, 2022
Accepted:
September 8,
2022
Received in revised form:
August 27,
2022
Received:
March 25,
2022
Footnotes
☆This study was supported in part by National Heart Lung and Blood Institute: R00-HL151887, The American Society of Transplant Surgeons Veloxis Fellowship Award, and The University of Colorado's Academic Enrichment Fund.
Identification
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