Evidence map›Paper›PMID 41922676›Full record

ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2026

Prothrombin complex concentrate use in liver transplantation: an international survey of current practices.

Isabella Kojundzic, Neeki Alavi, Keyvan Karkouti, Jeannie Callum, Matthanja Bieze, Carla Luzzi, Chaya Shwaartz, Wilton van Klei, Stuart A McCluskey, Justyna Bartoszko

Abstract readMulticenter Study
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In one paragraph

Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Isabella KojundzicDepartment of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Neeki AlaviDepartment of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Keyvan KarkoutiDepartment of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Jeannie CallumDepartment of Laboratory Medicine, Queen's University, Kingston, ON, Canada.
Matthanja BiezeDepartment of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Carla LuzziDepartment of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Chaya ShwaartzAjmera Transplant Centre, Toronto General Hospital,, University Health Network, Toronto, ON, Canada.
Wilton van KleiDepartment of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Stuart A McCluskeyDepartment of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada.
Justyna BartoszkoDepartment of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada. justyna.bartoszko@uhn.ca.ORCID 0000-0002-0738-0451

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProthrombin complex concentrate (PCC) is increasingly used for acquired coagulopathy in surgical patients, yet attitudes and usage patterns in liver transplantation are unclear. We sought to examine current practices of coagulopathy management during liver transplant surgery.

methodsWe conducted a cross-sectional, international multi-centre survey of anesthesiologists, intensivists, and surgeons caring for patients undergoing liver transplantation. The survey included closed and open-ended questions and assessed PCC usage patterns. For analysis, we used descriptive statistics using counts and proportions. We analyzed qualitative data to identify themes describing PCC use and priorities for future clinical trials.

resultsOriginating from 10 countries, 107 respondents participated, primarily anesthesiologists (88%). Prothrombin complex concentrate was used by 42%, avoided by 28%, and reserved for rescue treatment by 30%. While frozen plasma (82%) was preferred over PCC (16%) as first-line treatment for general coagulation factor deficiency, 14% preferred to avoid plasma altogether. Intraoperatively, viscoelastic testing (85%) was preferred to guide transfusion management; nevertheless, 43% of respondents reported no use of standardized transfusion algorithms at their institution. While clinicians indicated hesitancy to administer PCC to patients with a perceived higher risk of thromboembolism, they also strongly expressed hesitancy to administer plasma to patients with volume overload.

conclusionsThere is high variability in PCC use among clinicians administering transfusion in patients undergoing liver transplantation perioperatively. Clinicians perceived that PCC was likely beneficial for avoidance of volume overload, but a lack of comparative safety data to plasma was cited as a barrier to use. An adequately powered, high-quality randomized trial is required to guide evidence-based practice.

Indexed as

Blood Coagulation DisordersBlood Coagulation FactorsLiver TransplantationPractice Patterns, Physicians'AnesthesiologistsBlood TransfusionCross-Sectional StudiesHumansPlasmaSurveys and QuestionnairesBlood Coagulation Factorsprothrombin complex concentratesblood coagulation disordersblood transfusionend-stage liver diseasehepatic transplantationliver transplant, prothrombin complex concentrates

Identifiers

PMID41922676

What OpenQuestion holds

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Registered trials

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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.