Continuous versus intermittent infusion of human antithrombin III concentrate in the immediate postoperative period after liver transplantationopen access
- Authors
- Kim, Bo Rim; Lim, Leerang; Choi, YoungRok; Yi, Nam-Joon; Lee, Kwang-Woong; Suh, Kyung-Suk; Yu, Kyung-Sang; Sohn, Jin Young; Jeong, Raewon; Oh, Jaeseong; Ryu, Ho Geol
- Issue Date
- Jul-2023
- Publisher
- Wiley-Blackwell
- Citation
- Clinical and Translational Science, v.16, no.7, pp 1177 - 1185
- Pages
- 9
- Indexed
- SCIE
SCOPUS
- Journal Title
- Clinical and Translational Science
- Volume
- 16
- Number
- 7
- Start Page
- 1177
- End Page
- 1185
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63223
- DOI
- 10.1111/cts.13521
- ISSN
- 1752-8054
1752-8062
- Abstract
- Antithrombin-III (AT-III) concentrates have been used in the immediate postoperative period after liver transplantation to prevent critical thrombosis. We aimed to investigate a more appropriate method for AT-III concentrate administration to maintain plasma AT-III activity level within the target range. In this randomized controlled trial, 130 adult patients undergoing living-donor liver transplantation were randomized to either the intermittent group or continuous group. In the intermittent group, 500 international units (IU) of AT-III concentrate were administered after liver transplantation and repeated every 6 h for 72 h. In the continuous group, 3000 IU of AT-III were continuously infused for 71 h after a loading dose of 2000 IU over 1 h. Plasma AT-III activity level was measured at 12, 24, 48, 72, and 84 h from the first AT-III administration. The primary outcome was the target (80%–120%) attainment rate at 72 h. Target attainment rates at other timepoints and associated complications were collected as secondary outcomes. A total of 107 patients were included in the analysis. The target attainment rates at 72 h post-dose were 30% and 62% in the intermittent group and continuous group, respectively (p = 0.003). Compared to the intermittent group, patients in the continuous group reached the target level more rapidly (12 vs. 24 h, median time, p < 0.001) and were more likely to remain in the target range until 84 h. For maintaining the target plasma AT-III activity level after living-donor liver transplantation, continuous infusion of AT-III seemed to be more appropriate compared to the conventional intermittent infusion regimen.
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Collections - 2. Clinical Science > Department of Anesthesiology and Pain Medicine > 1. Journal Articles
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