Evidence map›Paper›PMID 40945996›Full record

SynthesisBritish journal of anaesthesia2025

Use of prothrombin complex concentrates in liver transplantation: a systematic review and meta-analysis.

Isabella Kojundzic, Neeki Alavi, Austin Lam, Keyvan Karkouti, Jeannie Callum, Matthanja Bieze, Carla Luzzi, Chaya Shwaartz, Marina Englesakis, François Martin Carrier and 10 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 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. Abdominal Organ Transplantation: Noteworthy Literature in 2025.Seminars in cardiothoracic and vascular anesthesia · 2026
    Review
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

20 authors.

Isabella KojundzicDepartment of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada; University of Ottawa Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Neeki AlaviDepartment of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Austin LamDepartment of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Keyvan KarkoutiDepartment of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada; Department of Anaesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Jeannie CallumDepartment of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada; Sunnybrook Research Institute, Toronto, Ontario, Canada.
Matthanja BiezeDepartment of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada; Department of Anaesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Erasmus Medical Centre, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Carla LuzziDepartment of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada; Department of Anaesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Chaya ShwaartzAjmera Transplant Centre, Toronto General Hospital, University Health Network, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON, Canada.
Marina EnglesakisLibrary & Information Services, University Health Network, Toronto, ON, Canada.
François Martin CarrierDepartment of Anaesthesiology, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
Jan-Willem BoldinghDepartment of Anaesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Jaap-Jan VosDepartment of Anaesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Johannes P van den BergDepartment of Anaesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Klaus GörlingerDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany; Tem Innovations, Munich, Germany.
Christopher HarleDepartment of Anaesthesia and Perioperative Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
Adrienne CarrDepartment of Anaesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, Nova Scotia, Canada.
Ton LismanFaculty of Medical Sciences, University of Groningen, Groningen, The Netherlands; Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Wilton A van KleiDepartment of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada; Department of Anaesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada; Department of Anaesthesiology, Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
Stuart A McCluskeyDepartment of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada; Department of Anaesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Justyna BartoszkoDepartment of Anaesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada; Department of Anaesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. Electronic address: justyna.bartoszko@uhn.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLiver transplantation (LT) can be a high transfusion procedure. Frozen plasma (FP) is widely used despite mixed efficacy and safety data. Several centres perform LT with no or low volume of FP by using prothrombin complex concentrate (PCC). This systematic review and meta-analysis characterises the existing efficacy and safety data of PCC use in LT.

methodsThis review was registered (PROSPERO CRD#42024561866). MEDLINE, Embase, Cochrane, and ClinicalTrials.gov were searched from inception to 30 May 2024. Studies in adults undergoing LT where PCC exposure was reported in relation to clinical outcomes were included. Random effects models were used to obtain pooled effect estimates.

resultsAll studies were retrospective, with seven reporting the number of patients receiving PCC [392/1901 (21%)], and one grouping patients receiving different factor concentrates together [576/939 (61%)]. Patients receiving PCC had worse preoperative coagulopathy, model for end-stage liver disease scores, and comorbidities. Patients exposed to PCC had a comparable mean number of red blood cell (RBC), plasma, or platelet units transfused. Use of viscoelastic testing-based algorithms incorporating PCC compared with usual care was associated with reduced odds of RBC exposure (odds ratio [OR]: 0.53, 95% confidence interval [CI]: 0.32-0.86, I

conclusionsAlthough there are no randomised trials comparing use of PCC vs FP in LT, their efficacy and safety appear comparable. Higher-quality studies are needed to assess PCC use for coagulopathic bleeding in LT.

Indexed as

Blood Coagulation FactorsLiver TransplantationBlood Loss, SurgicalHumansBlood Coagulation Factorsprothrombin complex concentratesblood coagulation disordersblood transfusionend-stage liver diseaseliver transplantationprothrombin complex concentrates

Identifiers

PMID40945996
PMCPMC12597362

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.