原位肝移植中的抗纤溶药物：现状与争议

Antifibrinolytics in orthotopic liver transplantation: current status and controversies.

作者信息

Xia Victor W, Steadman Randolph H

机构信息

Department of Anesthesiology, Liver Transplant Service, David Geffen School of Medicine, University of California, Box 951778, Los Angeles, Los Angeles, CA 90095, USA.

出版信息

Liver Transpl. 2005 Jan;11(1):10-8. doi: 10.1002/lt.20275.

DOI:10.1002/lt.20275

PMID:15690531

Abstract

This article reviews the current status and controversies of the 3 commonly used antifibrinolytics-epsilon-aminocaproic acid, tranexamic acid and aprotinin-during liver transplantation. There is no general consensus on how, when or which antifibrinolytics should be used in liver transplantation. Although these drugs appear to reduce blood loss and decrease transfusion requirements during liver transplantation, their use is not supported uniformly in clinical trials. Aprotinin has been studied more extensively in clinical trials and appear to offer more advantages compared to two other antifibrinolytics. Because of the diverse population of liver transplant recipients and the potential adverse effects of antifibrinolytics, especially life-threatening thromboembolism, careful patient selection and close monitoring is prudent. Further studies addressing the risks and benefits of antifibrinolytics in the setting of liver transplantation are warranted.

摘要

本文综述了肝移植过程中3种常用抗纤溶药物——ε-氨基己酸、氨甲环酸和抑肽酶的现状及争议。对于在肝移植中如何、何时或使用哪种抗纤溶药物，目前尚无普遍共识。尽管这些药物似乎能减少肝移植过程中的失血并降低输血需求，但在临床试验中它们的使用并未得到一致支持。抑肽酶在临床试验中得到了更广泛的研究，与其他两种抗纤溶药物相比，似乎具有更多优势。由于肝移植受者群体的多样性以及抗纤溶药物的潜在不良反应，尤其是危及生命的血栓栓塞，谨慎选择患者并密切监测是明智的。有必要进一步研究抗纤溶药物在肝移植中的风险和益处。