Liver transplantationComplications: ThromboticEarly Aspirin Therapy May Reduce Hepatic Artery Thrombosis in Liver Transplantation
Section snippets
Study Design and Treatment
This cross-sectional analysis included all adult OLT performed between 2000 and 2009. Patients were grouped and compared based on whether they received early posttransplant initiation of ASA. ASA therapy began once hemostasis occurred; therapy was delayed for ≤ 96 hours in cases of severe thrombocytopenia, defined as decreased platelets in the blood, reoperation, or continued bleeding. The dosage of ASA was 325 mg PO/NG daily and was continued for 3 months. After this time period, the therapy
Methods
Primary outcomes of this study included the safety and efficacy of early ASA therapy in adult liver transplantations recipients to prevent HAT. HAT was defined radiographically, usually through ultrasonography, with confirmation either by surgical exploration or angiography. Efficacy analysis included prevalence of both early HAT, defined as occurring within the first 30 days post-OLT, and late HAT, defined as occurring after the first 30 days post-OLT, with a focus on early HAT leading to
Patients
Five hundred forty-one OLT were performed at our institution between 2000 and 2009, with 72 patients being excluded (28 pediatrics, 19 multiorgan transplants, and 25 incomplete data). This left a total of 469 cases that met inclusion criteria and had complete data; these patients were analyzed in the study: 165 patients received ASA therapy and 304 patients did not. Baseline demographics between groups were similar, with the exception of age and mean liver transplantation year (Table 1).
HAT
Table 2
Discussion
An enhanced understanding of the development of HAT and interventions to minimize this potentially devastating surgical complication has become a major focus in OLT. In this study, we show that ASA therapy is both safe and effective in reducing early HAT leading to graft loss in adult OLT recipients. The incidence of early HAT leading to graft loss in the control group was found to be significantly higher when compared with the group receiving ASA therapy. In addition, there were no increases
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