Nicolau-Raducu, Ramona; Ku, Timothy C.; Ganier, Donald R.; Evans, Brian M.; Koveleskie, Joseph; Daly, William J., Jr.; Fish, Brian; Cohen, Ari J.; Reichman, Trevor W.; Bohorquez, Humberto E.; Bruce, David S.; Carmody, Ian C.; Loss, George E.; Gitman, Marina; Marshall, Thomas; Nossaman, Bobby D.
Abstract
Objectives: To examine the role of epsilon-aminocaproic acid (EACA) administered after reperfusion of the donor liver in the incidences of thromboembolic events and acute kidney injury within 30 days after orthotopic liver transplantation. One-year survival rates between the EACA-treated and EACA-nontreated groups also were examined.; Design: Retrospective, observational, cohort study design.; Setting: Single-center, university hospital.; Participants: The study included 708 adult liver transplantations performed from 2008 to 2013.; Interventions: None.; Measurements and Main Results: EACA administration was not associated with incidences of intracardiac thrombosis/pulmonary embolism (1.3%) or intraoperative death (0.6%). Logistic regression (n = 708) revealed 2 independent risk factors associated with myocardial ischemia (age and pre-transplant vasopressor use) and 8 risk factors associated with the need for post-transplant dialysis (age, female sex, redo orthotopic liver transplantation, preoperative sodium level, pre-transplant acute kidney injury or dialysis, platelet transfusion, and re-exploration within the first week after transplant); EACA was not identified as a risk factor for either outcome. One-year survival rates were similar between groups: 92% in EACA-treated group versus 93% in the EACA-nontreated group.; Conclusions: The antifibrinolytic, EACA, was not associated with an increased incidence of thromboembolic complications or postoperative acute kidney injury, and it did not alter 1-year survival after liver transplantation. (C) 2016 Elsevier Inc. All rights reserved.
