Low plasma levels of antithrombin III in the early post‐operative period following pediatric liver transplantation: Should they be replaced? A single‐center pilot study. (20th January 2014)

• Record Type: Journal Article
• Authors: Quintero, Jesús; Ortega, Juan; Miserachs, Mar; Bueno, Javier; Bilbao, Itxarone; Charco, Ramón
• Is Part Of: Pediatric transplantation. Volume 18:Number 2(2014:Mar.)
• Page Start: 185
• Page End: 189
• Publication Date: 2014-01-20
• Subjects: Transplantation of organs, tissues, etc. in children -- Periodicals; 617.95408305
• DOI: 10.1111/petr.12217
• Languages: English
• ISSNs: 1397-3142

Abstract

<abstract abstract-type="main" id="petr12217-abs-0001"> <title>Abstract</title> <p>eHAT after LT remains a life‐threatening complication. In the majority of anticoagulation protocols, heparin is used to prevent thromboses. Our study aimed to monitor AT‐III levels in the early post‐LT period to assess the need for the administration of AT‐III concentrate to ensure the effectiveness of heparin. We monitored coagulation daily by measuring INR, APTT, fibrinogen, platelets, and AT‐III. Anticoagulation therapy consisted of LMWH, AT‐III, and dipyridamole. AT‐III concentrate was administered when AT‐III activity was ≤60%. DUS was performed daily for the first five post‐operative days or whenever vascular thrombosis was suspected. Between October 2007 and October 2011, 39 LT were performed in our center. The median age was 26 months (6–196) with a median weight of 9 kg (5.5–49). AT‐III activity was ≤60% in 27 patients. Lower levels were particularly observed in partial grafts and recipients weighing less than 10 kg. Patent arterial flow was present in all 39 LT during the first five post‐operative days. AT‐III levels were low in 70% of pediatric patients following LT, thereby risking heparin ineffectiveness. These results may implicate low AT‐III levels in the etiology of eHAT post‐LT. However, this is a small single‐center pilot study and further larger prospective trials are required to confirm these results.</p> </abstract>