{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:20:22Z","timestamp":1763036422551,"version":"3.40.3"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2009,7,1]],"date-time":"2009-07-01T00:00:00Z","timestamp":1246406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2009,6,26]],"date-time":"2009-06-26T00:00:00Z","timestamp":1245974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000801","name":"Bayer HealthCare","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000801","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2009,7]]},"abstract":"<jats:title>\n                           <jats:bold>Abstract<\/jats:bold>\n                        <\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>Aprotinin is an antifibrinolytic drug that reduces blood loss during orthotopic liver transplantation (OLT). Case reports have suggested that aprotinin may be associated with an increased risk of thromboembolic complications. Recent studies in cardiac surgery also have suggested a higher risk of renal failure and postoperative mortality. Despite these concerns, no large-scale safety assessment has been performed in OLT. In a retrospective observational study involving 1492 liver transplants, we studied the occurrence of postoperative thromboembolic or thrombotic events and mortality in patients who received aprotinin (n = 907) and patients who did not (n = 585). The overall incidence of hepatic artery thrombosis and central venous complications (pulmonary embolism or inferior vena cava thrombosis) was 3.2% and 0.9%, respectively. In propensity score\u2013adjusted analyses (C-index = 0.79), aprotinin was not associated with an increased risk of hepatic artery thrombosis [odds ratio (OR) = 1.00, 95% confidence interval (CI) = 0.50-2.01, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.86]. Although central venous complications were found more frequently in patients receiving aprotinin, the difference was not statistically significant (OR = 2.95, 95% CI = 0.54-16.23, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.32). In addition, no significant differences were found in 1-year mortality (OR = 1.21, 95% CI = 0.86-1.71, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.32). In conclusion, this study did not demonstrate an increased risk of thrombotic complications or mortality when aprotinin is used during OLT. Liver Transpl 15:747\u2013753, 2009. \u00a9 2009 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.21768","type":"journal-article","created":{"date-parts":[[2009,6,26]],"date-time":"2009-06-26T14:28:15Z","timestamp":1246026495000},"page":"747-753","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":27,"title":["Aprotinin and the Risk of Thrombotic Complications After Liver Transplantation: A Retrospective Analysis of 1492 Patients"],"prefix":"10.1097","volume":"15","author":[{"given":"Nienke","family":"Warnaar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan V.","family":"Mallett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John R.","family":"Klinck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marieke T.","family":"de Boer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Rolando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew K.","family":"Burroughs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neville V.","family":"Jamieson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Rolles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Porte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-11-20250326","doi-asserted-by":"crossref","first-page":"2904","DOI":"10.1001\/jama.1983.03340210008003","article-title":"Liver transplants: big business in blood.","volume":"250","author":"Goldsmith","year":"1983","journal-title":"JAMA"},{"key":"R2-11-20250326","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1046\/j.1537-2995.1987.27387235624.x","article-title":"Blood use in liver transplantation.","volume":"27","author":"Lewis","year":"1987","journal-title":"Transfusion"},{"key":"R3-11-20250326","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1002\/lt.500030620","article-title":"A surgeons perspective on the management of coagulation disorders before liver transplantation.","volume":"3","author":"Bechstein","year":"1997","journal-title":"Liver Transpl Surg"},{"key":"R4-11-20250326","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1055\/s-2007-994025","article-title":"Coagulation and fibrinolysis in orthotopic liver transplantation: current views and insights.","volume":"19","author":"Porte","year":"1993","journal-title":"Semin Thromb Hemost"},{"key":"R5-11-20250326","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1213\/00000539-198509000-00008","article-title":"Intraoperative changes in blood coagulation and thrombelastographic monitoring in liver transplantation.","volume":"64","author":"Kang","year":"1985","journal-title":"Anesth Analg"},{"key":"R6-11-20250326","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1159\/000088056","article-title":"Minimizing blood loss in liver transplantation: progress through research and evolution of techniques.","volume":"22","author":"de Boer","year":"2005","journal-title":"Dig Surg"},{"key":"R7-11-20250326","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1056\/NEJM199807233390407","article-title":"Hemostatic drugs.","volume":"339","author":"Mannucci","year":"1998","journal-title":"N Engl J Med"},{"key":"R8-11-20250326","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1016\/0140-6736(90)92404-6","article-title":"Aprotinin and reduction of blood loss and transfusion requirements in orthotopic liver transplantation.","volume":"336","author":"Mallett","year":"1990","journal-title":"Lancet"},{"key":"R9-11-20250326","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/S0140-6736(89)91592-4","article-title":"Effect of aprotinin on intraoperative bleeding and fibrinolysis in liver transplantation.","volume":"2","author":"Neuhaus","year":"1989","journal-title":"Lancet"},{"key":"R10-11-20250326","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/S0140-6736(00)02111-5","article-title":"Aprotinin and transfusion requirements in orthotopic liver transplantation: a multicentre randomised doubleblind study. 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