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“Plasma Free” Perioperative Approach during Lung Transplantation Seems to Decrease FXIII Level which Is Not Clinically Significant

1University Hospital Motol, Charles University, Department of Anesthesiology and Intensive Care Medicine, Prague, Czech Republic, 2Motol University Hospital, Department of Clinical Haematology, Prague, Czech Republic, 3Section Haematology Laboratory, University Hospital Kralovske Vinohrady, Department of Laboratory Diagnostics, Prague, Czech Republic

Abstract Number: PB0269

Meeting: ISTH 2020 Congress

Theme: Coagulation and Natural Anticoagulants » Critical Care and Perioperative

Background: Lung transplantation surgery is often performed on extracorporeal membrane oxygenation (ECMO) which is generally associated with coagulopathy and bleeding. Fresh frozen plasma (FFP) might be a source of clotting factors to support coagulation but on the other hand it may be associated with higher morbidity and mortality of patients in general.

Aims: The aim of this study was to find out whether point of care (POC) approach to diagnosis of perioperative coagulopathy may decrease consumption of FFP and whether it will impair level of FXIII, secondary hemostasis measured by ROTEM and blood loss.

Methods: In this randomized study, 28 patients undergoing lung transplantation (most of them done on ECMO) were analyzed. Fourteen patients were treated using standard approach based on administering of FFP during bleeding (non POC group) and 14 patients were treated on the base of POC tests (POC group) such as ROTEM (administering prothrombin complex concentrate, platelets, fibrinogen). ROTEM (EXTEM and FIBTEM) exam and level of FXIII was measured before and after surgery in both groups and perioperative blood loss was evaluated, as well.

Results: In POC group no FFP was administered during lung transplantation surgery. This approach actually enabled ,,plasma free” perioperative management. There was significantly decreased level of FXIII in POC group after surgery (p < 0.05) but blood loss was paradoxically lower in the same group. MCF of EXTEM and FIBTEM was not different between both groups. Data are shown on Figure 1.

Conclusions: “Plasma free” perioperative management of lung transplantation surgery, based on POC results, decreases FXIII level which is not clinically significant.
Acknowledgement: The study was supported by Supported by Ministry of Health, Czech Republic – conceptual development of research organization, Motol Univesity Hospital, Prague,Czech Republic 00064203.

[Fig 1 Measurements of MCF (maximum clot firmness) of EXTEM and FIBTEM, level of FXIII and blood loss]

To cite this abstract in AMA style:

Durila M, Solcova M, Mikesova M, Vajter J, Vymazal T. “Plasma Free” Perioperative Approach during Lung Transplantation Seems to Decrease FXIII Level which Is Not Clinically Significant [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/plasma-free-perioperative-approach-during-lung-transplantation-seems-to-decrease-fxiii-level-which-is-not-clinically-significant/. Accessed December 6, 2023.

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