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Published on: February 28, 2012
Warfarin therapy does not increase bleeding in patients undergoing heart transplantation
C D Morris1, J D Vega, J H Levy
1Joseph B. Whitehead Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
The Annals of Thoracic Surgery
|September 22, 2001
Summary
Continuing warfarin therapy before heart transplantation is safe. This study found no increased bleeding risk, suggesting preoperative warfarin can be safely maintained in heart transplant candidates.
Area of Science:
- Cardiology
- Transplantation Medicine
- Anesthesiology
Background:
- Historically, warfarin use in heart transplant candidates was limited due to bleeding concerns.
- Warfarin's impact on perioperative bleeding in cardiac surgery required further investigation.
Purpose of the Study:
- To assess the safety and risks of continuing warfarin therapy in patients undergoing heart transplantation.
- To determine if preoperative warfarin affects bleeding complications post-transplant.
Main Methods:
- Retrospective review of adult heart transplant recipients from 1996-1998.
- Analysis of preoperative and postoperative data, including International Normalized Ratio (INR), blood product usage, and chest tube drainage.
- Multivariate regression analysis to identify risk factors for bleeding.
Main Results:
- No correlation found between preoperative or postoperative INR and chest tube drainage.
- Inverse relationships observed between postoperative INR and total blood product administration (platelets, fresh frozen plasma, red cells).
- Preoperative INR did not correlate with bleeding when fresh frozen plasma use was accounted for.
Conclusions:
- Continuing preoperative warfarin therapy does not increase chest tube output in heart transplant recipients.
- Inverse relationships between INR and transfusion requirements suggest warfarin may mitigate bleeding.
- Preoperative warfarin can be safely continued in patients awaiting heart transplantation.
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