Luo Yuanyuan, Ma Chunya, Yu Yang
Department of Transfusion Medicine, First Medical Center of PLA General Hospital, Beijing, P. R. China.
Blood Sci. 2022 May 17;4(2):57-64. doi: 10.1097/BS9.0000000000000108. eCollection 2022 Apr.
Warfarin is a commonly used oral anticoagulant. Patients with artificial valve replacement, atrial fibrillation, pulmonary embolism, deep vein thrombosis, and other diseases require long-term anticoagulant oral treatment with warfarin. As warfarin exhibits prompt action with long maintenance time, it has become a key drug for the treatment of patients at risk of developing thrombosis or thromboembolism. Warfarin is a bican coumarin anticoagulant, that exhibits competitive action against vitamin K as its mechanism of action, thereby inhibiting the synthesis of coagulation factors-predominantly the vitamin K-dependent coagulation factors II, VII, IX, and X-in hepatocytes. Long-term warfarin is known to significantly increase the risk of organ bleeding in some patients, while some patients may need to reverse the anticoagulation effect. For instance, patients scheduled for emergency or invasive surgery may require rapid anticoagulation reversal. During such medical circumstances, fresh frozen plasma (FFP) is clinically used for the reversal of excess warfarin-associated anticoagulation, as it contains all the coagulation factors that can alleviate the abnormal blood anticoagulation status in such patients. Accordingly, this article aims to perform an in-depth review of relevant literature on the reversal of warfarin with FFP, and insightful deliberation of the application and efficacy of this clinical intervention.
华法林是一种常用的口服抗凝剂。接受人工瓣膜置换、患有房颤、肺栓塞、深静脉血栓形成等疾病的患者需要长期口服华法林进行抗凝治疗。由于华法林起效迅速且维持时间长，它已成为治疗有发生血栓形成或血栓栓塞风险患者的关键药物。华法林是一种双香豆素类抗凝剂，其作用机制是对维生素K表现出竞争性作用，从而抑制肝细胞中凝血因子的合成，主要是维生素K依赖的凝血因子II、VII、IX和X。众所周知，长期使用华法林会显著增加一些患者器官出血的风险，而一些患者可能需要逆转抗凝效果。例如，计划进行急诊或侵入性手术的患者可能需要快速逆转抗凝作用。在这种医疗情况下，新鲜冰冻血浆（FFP）在临床上用于逆转华法林相关的过量抗凝，因为它含有所有能缓解此类患者血液抗凝异常状态的凝血因子。因此，本文旨在对有关FFP逆转华法林的相关文献进行深入综述，并对这种临床干预的应用和疗效进行深入探讨。
