Document Detail

Use of activated protein C in liver transplantation patients with septic shock.
MedLine Citation:
PMID:  18972572     Owner:  NLM     Status:  MEDLINE    
Recombinant human activated protein C (rhAPC) has been approved for use in patients with severe sepsis at high risk of death. Because of the high risk of bleeding, liver transplantation (LT) patients have been excluded from the randomized control trials that evaluated efficacy and safety of rhAPC and, thus, few data are available on the use of this drug in LT patients with severe sepsis. We describe our experience with 5 LT recipients treated for septic shock with the best conventional therapy and rhAPC. Before rhAPC therapy, all the patients showed septic shock, with > or =3 organ dysfunctions and thrombocytopenia with impairment of coagulation. rhAPC therapy started within 30 hours after septic shock onset in all the patients who recovered from sepsis-induced circulatory failure, improved organ dysfunction, and completed the 96 hours of rhAPC therapy. During rhAPC infusion, 4 patients received fresh frozen plasma and/or platelet concentrates because of thrombocytopenia and severe hemostasis dysfunction. No major bleeding occurred and only 1 patient presented with minor bleeding events.
Laura Rinaldi; Marco Marietta; Mariano Alejandro Mignini; Lara Donno; Stefano Busani; Mauro Codeluppi; Michele Masetti; Massimo Girardis
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society     Volume:  14     ISSN:  1527-6473     ISO Abbreviation:  Liver Transpl.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-04     Completed Date:  2009-04-27     Revised Date:  2009-12-02    
Medline Journal Info:
Nlm Unique ID:  100909185     Medline TA:  Liver Transpl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1598-602     Citation Subset:  IM    
Department of Anaesthesiology and Intensive Care Unit, University of Modena and Reggio Emilia, University Hospital of Modena [corrected] Eli-Lilly Italia, Sesto Fiorentino, Italy.
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MeSH Terms
Age Factors
Hemorrhage / drug therapy
Liver Transplantation / methods*
Middle Aged
Platelet Count
Protein C / therapeutic use*
Recombinant Proteins / therapeutic use
Shock, Septic / therapy*
Thrombocytopenia / etiology
Treatment Outcome
Reg. No./Substance:
0/Protein C; 0/Recombinant Proteins
Comment In:
Liver Transpl. 2009 Dec;15(12):1901-2   [PMID:  19938105 ]
Erratum In:
Liver Transpl. 2009 Jan;15(1):119

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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