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Correcting prolonged bleeding during renal transplantation with estrogen or plasma
G L Boyd1, A G Diethelm, S Gelman
1Department of Anesthesiology, University of Alabama at Birmingham, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|February 1, 1996
Summary
Conjugated estrogens (CE) and fresh-frozen plasma (FFP) effectively reduced prolonged bleeding times in renal transplant patients. CE demonstrated a longer duration of action and may be preferred due to lower risk and cost.
Area of Science:
- Nephrology
- Transplantation Surgery
- Hematology
Background:
- Prolonged preoperative bleeding times pose a significant risk in renal transplantation.
- Effective management strategies are crucial to optimize surgical outcomes and patient safety.
Purpose of the Study:
- To evaluate the efficacy of conjugated estrogens (CE) and fresh-frozen plasma (FFP) in normalizing prolonged bleeding times before renal transplantation.
- To compare the relative effectiveness and duration of action of CE versus FFP.
Main Methods:
- A prospective, randomized trial was conducted at a university regional referral center.
- Patients with prolonged bleeding times (>10 minutes) received either CE or FFP post-anesthesia induction.
- Bleeding times were measured pre-operatively, at the end of surgery, and at 24 and 48 hours postoperatively.
Main Results:
- Both CE and FFP significantly reduced bleeding times by the end of surgery (P < .001).
- CE maintained significantly lower bleeding times at 24 and 48 hours compared to FFP (P < .001).
- The control group showed no significant change in bleeding times.
Conclusions:
- Both CE and FFP are effective in decreasing prolonged bleeding times during renal transplantation.
- CE may be the preferred treatment due to its sustained effect, lower risk profile, and cost-effectiveness.