Risk Factors for Postoperative Bleeding after Lung Transplantation

D. Adelmann,^1,2 S. Koch,¹ J. Menger,¹ P. Jaksch,³ M. Kurz,¹ M. Mouhieddine,¹ W. Klepetko,³ B. Steinlechner.¹

¹Department of Anesthesia, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria
²Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA
³Medical University of Vienna, Vienna, Austria.

Meeting: 2018 American Transplant Congress

Abstract number: C270

Keywords: Lung transplantation, Safety

Session Information

Session Name: Poster Session C: Lung: All Topics

Session Type: Poster Session

Date: Monday, June 4, 2018

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Bleeding complications after lung transplantation (LuTX) are associated with increased morbidity. Risk factors for postoperative bleeding complications after LuTX have not yet been reported. In cardiac surgery, low fibrinogen concentrations are associated with an increased risk for postoperative bleeding. The aim of this study was to describe the association between pre- and postoperative routine coagulation parameters, the perioperative use of extracorporeal membrane oxygenation (ECMO) and incidence of postoperative bleeding complications after lung transplantation.

All adult patients who underwent bilateral LuTX at the Medical University of Vienna from 01/01/2009 – 08/31/2015 were included in this analysis. Coagulation test results (aPTT, PT, Fibrinogen concentration, Platelet count) were collected preoperatively (the last available results before skin incision) and postoperatively (the first results after skin closure). Bleeding complications were defined as cases requiring surgical revision within 48 hours after transplant.

Out of 651 patients, 32 patients (5%) required surgical revision within 48 hours. Results of uni- and multivariate analysis are shown in table 1.

In this cohort study, low postoperative fibrinogen concentrations and the use of ECMO pre- and postoperatively were associated with an increased risk of postoperative bleeding.

Table 1:	No Bleeding	Bleeding	univariate analysis	multivariate analysis
ECMO preop	38 (6.1%)	16 (50.0%)	< 0.001	0.0001
ECMO intraop	453 (73.2%)	30 (93.8%)	0.02	n.S.
ECMO postop	146 (23.6%)	23 (71.9%)	< 0.001	0.008
Fibrinogen (mg/dl) preop	456 ± 131	445 ± 205	0.66	n.S.
Fibrinogen (mg/dl) postop	306 ± 76	235 ± 69	< 0.001	0.006
Platelet count (g/L)preop	273 ± 116	203 ± 113	0.001	n.S.
Platelet count (g/L)postop	130 ± 61	76 ± 38	< 0.001	n.S.
PT (%) preop	89 ± 23	81 ± 27	0.06	n.S.
PT (%) postop	83 ± 20	76 ± 23	0.048	n.S.
n(%) \| mean ± SD

CITATION INFORMATION: Adelmann D., Koch S., Menger J., Jaksch P., Kurz M., Mouhieddine M., Klepetko W., Steinlechner B. Risk Factors for Postoperative Bleeding after Lung Transplantation Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Adelmann D, Koch S, Menger J, Jaksch P, Kurz M, Mouhieddine M, Klepetko W, Steinlechner B. Risk Factors for Postoperative Bleeding after Lung Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/risk-factors-for-postoperative-bleeding-after-lung-transplantation/. Accessed November 21, 2024.

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