The use of coagulation factor concentrates for perioperative bleeding management – a global perspective

Transfusion ◽  
2020 ◽  
Vol 60 (4) ◽  
pp. 663-666
Author(s):  
Oliver Grottke ◽  
Jeannie Callum ◽  
Melissa M. Cushing ◽  
Thorsten Haas
Keyword(s):  
Coagulation Factor ◽  
Global Perspective ◽  
Bleeding Management ◽  
Perioperative Bleeding ◽  
Coagulation Factor Concentrates

The Year 2020 in Review: Noteworthy Literature for Thoracic Transplant Anesthesiologists

2021 ◽  
pp. 108925322110076
Author(s):  
Benjamin A. Abrams ◽  
Barbara Wilkey
Keyword(s):  
Lung Transplantation ◽  
Adult Congenital Heart Disease ◽  
Coagulation Factor ◽  
Preoperative Assessment ◽  
Total Artificial Heart ◽  
Donor Pool ◽  
Transplant Patients ◽  
Adult Congenital ◽  
Coagulation Factor Concentrates ◽  
Made In

The year 2020 was a monumental year in medicine, and this review focuses on selected articles for cardiothoracic anesthesiologists and perioperative physicians involved in the care of heart and lung transplant patients. In the field of lung transplantation, significant strides were made in our knowledge of risk stratification during the preoperative assessment of potential recipients, perioperative transfusion medicine, and the administration of coagulation factor concentrates. In addition, variations in perioperative management and outcomes between institutions were studied across an assortment of metrics regarding lung transplantation, including case volumes and anesthetic practices. Transitioning to topics in the field of heart transplantation, consideration was given to recipients with adult congenital heart disease, and separately, approaches to expanding the donor pool through donation after circulatory death. With regard to preoperative support, outcomes for the total artificial heart as well as the MitraClip as bridges to transplantation were published.

HIV-Antibody Seroconversions in Dutch Haemophiliacs Using Heat-Treated and Non Heat-Treated Coagulation Factor Concentrates

1988 ◽  
Vol 59 (03) ◽  
pp. 396-399 ◽  
Author(s):  
Tom F W Wolfs ◽  
Cees Breederveld ◽  
Willy J A Krone ◽  
Lia v d Hoek ◽  
Margreet Bakker ◽  
...  
Keyword(s):  
High Risk ◽  
Multicentre Study ◽  
Blood Donors ◽  
Seroconversion Rate ◽  
Coagulation Factor ◽  
Donor Screening ◽  
Heat Treated ◽  
Hiv Antibodies ◽  
Coagulation Factor Concentrates

SummaryA national multicentre study was performed to investigate the effects of donorselection and the use of heat-treated plasma products on seroconversion to HIV in 157 Dutch haemophiliacs. All patients included in the study were seronegative for HIV antibodies in 1983.Thirteen percent (20/157) seroconverted between 1983 and 1986. Nineteen of 20 seroconversions could be related to the use of non heat-treated products in the year preceding HIV antibody seroconversion. One seroconversion occurred in a person using heat-treated non donor screened product.Seroconversion rate decreased as a result of the policy to discourage high risk blood donors and no seroconversions were observed following the introduction of donor screening in 1985.

scholarly journals Dynamics of Platelet Counts in Major Trauma: The Impact of Haemostatic Resuscitation and Effects of Platelet Transfusion—A Sub-Study of the Randomized Controlled RETIC Trial

2020 ◽  
Vol 9 (8) ◽  
pp. 2420
Author(s):  
Helmuth Tauber ◽  
Nicole Innerhofer ◽  
Daniel von Langen ◽  
Mathias Ströhle ◽  
Dietmar Fries ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Platelet Transfusion ◽  
Major Trauma ◽  
Coagulation Factor ◽  
Trauma Patients ◽  
First Line ◽  
Platelet Counts ◽  
Randomized Controlled ◽  
Coagulation Factor Concentrates ◽  
Haemostatic Resuscitation

Although platelets play a central role in haemostasis, the dynamics of platelet counts during haemostatic resuscitation, the response to platelet transfusion, and effects on clinical outcome are poorly described for trauma patients. As a sub-study of the already published randomized controlled RETIC Study “Reversal of Trauma-induced Coagulopathy using First-line Coagulation Factor Concentrates or Fresh-Frozen Plasma” trial, we here analysed whether the type of first-line haemostatic resuscitation influences the frequency of platelet transfusion and determined the effects of platelet transfusion in coagulopathic patients with major trauma. Patients randomly received first-line plasma (FFP) or coagulation factor concentrates (CFC), mainly fibrinogen concentrate. In both groups, platelets were transfused to maintain platelet counts between 50 and 100 × 109/L. Transfusion rates were significantly higher in the FFP (n = 44) vs. CFC (n = 50) group (FFP 47.7% vs. CFC 26%); p = 0.0335. Logistic regression analysis adjusted for the stratification variables injury severity score (ISS) and brain injury confirmed that first-line FFP therapy increases the odds for platelet transfusion (odds ratio (OR) 5.79 (1.89 to 20.62), p = 0.0036) and this effect was larger than a 16-point increase in ISS (OR 4.33 (2.17 to 9.74), p = 0.0001). In conclusion, early fibrinogen supplementation exerted a platelet-saving effect while platelet transfusions did not substantially improve platelet count and might contribute to poor clinical outcome.

Perioperative management of coagulation

2006 ◽  
Vol 26 (S 02) ◽  
pp. S3-S14 ◽  
Author(s):  
P. Innerhofer
Keyword(s):  
Coagulation Factor ◽  
Fresh Frozen Plasma ◽  
Laboratory Evaluation ◽  
Blood Component ◽  
Actual Case ◽  
Fresh Frozen ◽  
Coagulation Factor Concentrates ◽  
Hemostatic Therapy ◽  
Frozen Plasma

SummaryGuidelines of official societies for diagnosis and therapy of intraoperatively occurring hypocoagulability rely mainly on data of patients receiving whole blood transfusions. They recommend -provided that laboratory evaluation shows deficiency (values >1.5 fold normal)- administration of fresh frozen plasma, cryoprecipitate and platelet concentrates (platelet count <50 000 or <100 000/μl). This article describes the pathogenesis of coagulopathy in the light of the special intraoperative setting, emphasizes recent changes of blood component preparation, transfusion triggers, effects of volume therapy and challenges standard laboratory assays as reliable guide for intraoperative hemostatic therapy. The role of thrombelastographic monitoring is discussed as well as an alternative strategy to compensate deficiencies by the use of coagulation factor concentrates instead of or in addition to transfusion of FFP, a new concept which is illustrated by the presentation of an actual case report.

Bleeding Complications in Acute Myeloblastic Leukaemia (AML)

1979 ◽  
Author(s):  
A.H. Sutor
Keyword(s):  
Coagulation Factor ◽  
Bleeding Complications ◽  
Consumption Coagulopathy ◽  
Acute Myeloblastic Leukaemia ◽  
Coagulation Factor Concentrates ◽  
Blast Count ◽  
Plasmatic Coagulation ◽  
Coagulation And Fibrinolysis

Bleeding is common in acute myeloblastic leukaemia (From our experience with 30 children suffering from AML we drew the following conclusions: At the time of diagnosis, the danger of bleeding cannot be predicted by laboratory means. However, the following factors represent increased risks: Promyeloblastic leukaemia, high blast count, low fibrinogen, low plasminogen. From coagulation studies performed at the time of bleeding complications, the pathomechanism leading to bleeding complications usually cannot be detected. The question, whether inpairment of production, consumption coagulopathy, or primary fibrinolysis causes the bleeding complications can only to answered by controlling frequently clinical and haemostatic criteria, which include the thrombocytic system as well as plasmatic coagulation and fibrinolysis. At the present time, the therapy of bleeding complications in AML is symptomatic. It consists of transfusion with thromlocytes or fresh whole wood , respectively. Coagulation factor concentrates shouls only be given in combination with Heparin to prevent the deterioration of consumption coagulopathy.

Effect of High- versus Intermediate-Purity Blood Coagulation Factor Concentrates on HIV-1 Replication

Vox Sanguinis ◽  
1996 ◽  
Vol 70 (4) ◽  
pp. 195-197 ◽  
Author(s):  
Daniela Schögl ◽  
Klaus Zimmermann ◽  
Peter L. Turecek ◽  
Hans Peter Schwarz ◽  
Martha M. Eibl ◽  
...  
Keyword(s):  
Blood Coagulation ◽  
Coagulation Factor ◽  
Coagulation Factor Concentrates ◽  
Hiv 1

INACTIVATION OF HEPATITIS VIRUSES AND HIV IN PLASMA AND PLASMA DERIVATIVES BY COMBINED TREATMENTWITH β-PR0PI0LACT0NE/UV-IRRADIATION

1987 ◽  
Author(s):  
W Stephan ◽  
H Dichtelmüller ◽  
A M Prince ◽  
L Gürtler ◽  
F Deinhardt
Keyword(s):  
Reverse Transcriptase ◽  
Human Plasma ◽  
Uv Irradiation ◽  
Combined Treatment ◽  
Coagulation Factor ◽  
Hepatitis Viruses ◽  
Reverse Transcriptase Assay ◽  
Coagulation Factor Concentrates ◽  
Virucidal Efficacy

A combined treatment of plasma andplasma derivatives by β-Propiolactone (β-PL) /UV-irradiation is inuse at Biotest for the preparation ofthe virus safe serum preserve Bisekd® and coagulation factor concentrates.The efficacy of this sterilization procedure has been demonstrated for HAV(> 8.2 log10), HBV ( 7.0 log10) and HNANB (> 4.5 log10). As HIV has become a major problem tne inactivation of HIV by β-PL/UV in human plasma was tested. Pooled human plasma was spiked with 104.2 infectious units per ml of the Gallo strain of HIV/ HTLV-III and sterilized with 0.25 % β-PL, 60 min at pH 7.2 and subsequently UV-irradiated (4 × 20 W). After treatment with β-PL alone orβ-PL/UV no infectious HIV was detectable by reverse transcriptase assay in inoculated H-9 cultures after 14 days of cultivation (> 4.2 log10 inactivation). When the virucidal efficacy of ft-PL and UV was tested separately, β-PL inactivated > 3.5 log10, UV-irradiation another 2.5 log10 of HIV, as demonstrated by immunofluorescence tests in H-9 cultures 27 daysafter inoculation.When cryoprecipitate/F VUI-concentrate was sterilized by ft-PL and UV, > 4.5 log10 of HIV were inactivated by UV and > 3.5 log10 by α-PL. The results indicate, that the combined treatment by β-PL/UV inactivates all potentialtiters of HIV, which can be expected inscreened and pooled human plasma orcryoprecipitate, used for the preparation of virus safe plasma derivatives.

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