| Different aprotinin applications influencing hemostatic changes in orthotopic liver transplantation. | |
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MedLine Citation:
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PMID: 1370735 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The effect of different aprotinin applications on hemostatic changes and blood product requirements in orthotopic liver transplantation was investigated in a prospective, open, and randomized study. From November 1989 to June 1990, 13 patients received aprotinin as a bolus of 0.5 Mill. Kallikrein inactivator units (KIU) on three occasions in the course of an OLT, whereas 10 other patients were treated with continuous aprotinin infusion of 0.1-0.4 Mill. KIU/hr. Before and after reperfusion of the graft liver, signs of hyperfibrinolysis, measured by thrombelastography, were significantly lower in the infusion group. Tissue-type plasminogen activator (t-PA) activity increased during the anhepatic phase but to a significantly lesser extent in the infusion group. Blood product requirements during OLT were tendentiously higher in the bolus group but not significantly so. However, the use of packed red blood cells was significantly lower in the postoperative period, whereas there was no significant difference in fresh frozen plasma requirements between the two groups. All 23 patients have survived, and only one woman of each group required retransplantation due to severe host-versus-graft reactions. Furthermore, we investigated the perfusate of the graft liver in both groups and detected signs of a decreased t-PA release in the infusion group. Our results demonstrate an advantage of aprotinin given as continuous infusion over bolus application in OLT. |
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Authors:
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G Himmelreich; M Muser; P Neuhaus; W O Bechstein; K J Slama; M Jochum; H Riess |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Transplantation Volume: 53 ISSN: 0041-1337 ISO Abbreviation: Transplantation Publication Date: 1992 Jan |
Date Detail:
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Created Date: 1992-02-24 Completed Date: 1992-02-24 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0132144 Medline TA: Transplantation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 132-6 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, University Hospital, Berlin, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aprotinin
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administration & dosage*,
pharmacology Drug Administration Schedule Fibrinolysis / drug effects Hemostasis / drug effects* Humans Liver Transplantation* Prospective Studies Random Allocation Tissue Plasminogen Activator / analysis |
| Chemical | |
Reg. No./Substance:
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9087-70-1/Aprotinin; EC 3.4.21.68/Tissue Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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