Evidence map›Paper›PMID 39813557›Full record

ArticleArquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery2025

INTERNATIONAL NORMALIZED RATIO AND ACTIVATED PARTIAL THROMBOPLASTIN TIME DO NOT PREDICT PLASMA TRANSFUSION IN LIVER TRANSPLANTATION.

David Silveira Marinho, Joel Avancini Rocha Filho, Estela Regina Ramos Figueira, Claudia Regina Fernandes, Rui Carlos Detsch Junior, José Huygens Parente Garcia, Wellington Andraus, Luiz Augusto Carneiro D'Albuquerque

Abstract read
In one paragraph

Article in Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Preventive correction of fibrinolysis with epsilon aminocaproic acid detected by thromboelastometry during liver transplantation.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2025
    Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

David Silveira MarinhoDepartment of Anesthesiology, Faculty of Medicine, Universidade Federal do Ceará - Fortaleza (CE), Brazil.ORCID http://orcid.org/0000-0002-9107-9206
Joel Avancini Rocha FilhoAnesthesiology Unit, Hospital das Clinicas, Faculty of Medicine - Universidade de São Paulo, São Paulo (SP), Brazil.ORCID http://orcid.org/0000-0001-5439-5907
Estela Regina Ramos FigueiraDepartment of Gastroenterology, Hospital das Clinicas, Faculty of Medicine, Universidade de São Paulo - São Paulo (SP), Brazil.ORCID http://orcid.org/0000-0002-7856-8670
Claudia Regina FernandesDepartment of Anesthesiology, Faculty of Medicine, Universidade Federal do Ceará - Fortaleza (CE), Brazil.ORCID http://orcid.org/0000-0003-2366-2341
Rui Carlos Detsch JuniorAnesthesiology Unit, Hospital das Clinicas, Faculty of Medicine - Universidade de São Paulo, São Paulo (SP), Brazil.ORCID http://orcid.org/0009-0001-6260-3523
José Huygens Parente GarciaDepartment of Surgery, Faculty of Medicine, Universidade Federal do Ceará - Fortaleza (CE), Brazil.ORCID http://orcid.org/0000-0003-4401-137X
Wellington AndrausDepartment of Gastroenterology, Hospital das Clinicas, Faculty of Medicine, Universidade de São Paulo - São Paulo (SP), Brazil.ORCID http://orcid.org/0000-0002-5162-138X
Luiz Augusto Carneiro D'AlbuquerqueDepartment of Gastroenterology, Hospital das Clinicas, Faculty of Medicine, Universidade de São Paulo - São Paulo (SP), Brazil.ORCID http://orcid.org/0000-0001-7607-7168

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBlood loss during liver transplantation (LT) remains a major concern associated with increased morbidity and reduced patient and graft survival. The high complexity of the procedure associated with the multifaceted origin of the bleeding urges early identification of high-risk patients and proper monitoring of hemostasis disorders in order to improve results. The accuracy of international normalized ratio (INR) and activated partial thromboplastin time (aPTT) to evaluate coagulation status in cirrhotic patients has been doubted.

aimsThe aim of this study was to investigate the applicability of these coagulation tests to indicate fresh frozen plasma transfusion in LT.

methodsThis retrospective cohort study analyzed 297 cirrhotic patients submitted to LT. INR and aPTT were measured preoperatively and in each surgical phase. Hemostatic blood components were transfused only for coagulopathy indication. Patients were divided according to intraoperative plasma transfusion into transfused and non-transfused groups. The accuracy of INR and aPTT to predict plasma transfusions was investigated. The alert values of INR and aPTT unassociated with coagulopathy in each phase of surgery were identified.

resultsMultivariate analysis showed that preoperative hematocrit (odds ratio [OR]=0.90, p<0.001), preoperative fibrinogen (OR=0.99, p<0.001), and absence of hepatocellular carcinoma (OR=3.57, p=0.004) were significant predictors of plasma transfusions.

conclusionsINR and aPTT demonstrated poor accuracy in predicting plasma transfusions, irrespective of the cutoff adopted, highlighting the need for a more comprehensive approach to guide hemostatic therapy in LT to improve the outcome.

Indexed as

Blood Component TransfusionInternational Normalized RatioLiver TransplantationPlasmaAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedPartial Thromboplastin TimePredictive Value of TestsRetrospective Studies

Identifiers

PMID39813557
PMCPMC11729538

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