Risk Factors for Postoperative Bleeding after Lung Transplantation
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 May 16, 2025.« Back to 2018 American Transplant Congress