Four-factor Prothrombin Complex Concentrate During Liver Transplantation: A Retrospective Cohort Study.

Area of Science:

• Hepatology
• Transplantation Medicine
• Hematology

Background:

• Four-factor prothrombin complex concentrate (PCC) contains coagulation factors II, VII, IX, and X.
• PCC is used off-label to manage coagulopathy in orthotopic liver transplantation (OLT).
• Concerns exist regarding the thrombotic risk associated with PCC use in OLT.

Purpose of the Study:

• To evaluate the safety of four-factor PCC in patients undergoing OLT.
• To assess the incidence of thrombotic complications and mortality rates associated with PCC use during OLT.

Main Methods:

• Retrospective cohort study comparing 83 patients who received PCC during OLT with 83 matched controls.
• Evaluation of 30-day and 1-year mortality, thrombotic events (portal vein thrombosis, DVT, MI, PE), and ICU length of stay (LOS).
• Data collected from January 1, 2018, to May 1, 2022.

Main Results:

• No significant difference in 30-day mortality (OR 5; P=0.14) or 1-year mortality (OR 3; P=0.18) between groups.
• No significant increase in thrombotic complications within 90 days post-surgery, including portal vein thrombosis, PE, DVT, and MI.
• No significant difference in postoperative intensive care unit (ICU) length of stay (LOS).

Conclusions:

• PCC administration during OLT did not lead to a statistically significant increase in perioperative complications.
• The study suggests that PCC can be safely used in OLT without a significant rise in thrombotic events or ICU LOS.