Orthotopic liver transplantation (OLT) is associated with severe bleeding and considerable transfusion requirements. There are several reasons for this severe bleeding in OLT. Hemostatic abnormalities remain a major cause.
This study, performed by a team led by Professor Wang Xuehao, is to be published in the March 7, 2008 issue of the World Journal of Gastroenterology.
Aprotinin, a serine protease inhibitor, is used increasingly often in surgeries during operations such as cardiac surgery and liver transplantation to reduce bleeding and transfusion .We performed a meta-analysis to study the effect of aprotinin used in OLT on the intraoperative requirement of blood products and the postoperative outcomes. This study clearly showed that aprotinin can reduce the intraoperative requirement of blood products and has no significant effect on the incidence of laparotomy for bleeding, thromboembolic events and mortality.
In the view of the authors, there are still some conflicting results on whether aprotinin can reduce blood loss or requirement of transfusion in orthotopic liver transplantation, and whether it can be beneficial to the postoperative outcomes. A systematic review of the literature was performed in the electronic database of Medline and the Clinical Trials Registry Databases to study the effect of aprotinin used in OLT on the intraoperative requirement of blood products and on the incidence of laparotomy for bleeding, thrombotic events and mortality.
Using meta-analysis as the statistical method, this research was performed by doctors from the Department of Anesthesiology, First Affiliated Hospital, Nanjing Medical University.
More clinic researches are needed to confirm the result.
Reference: Liu CM, Chen J, Wang XH. Requirements for transfusion and postoperative outcomes in orthotopic liver transplantation: A meta-analysis on aprotinin. World J Gastroenterol 2008; 14(9): 1425-1429
http://www.wjgnet.com/1007-9327/14/1425.asp
Correspondence to: Cun-Ming Liu, Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029,Jiangsu Province, China. E-mail: mingliu870@sohu.com
Telephone: +86-25-83718836-6878
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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