Utility of prothrombin complex concentrate as first-line treatment modality of coagulopathy in patients undergoing liver transplantation: A propensity score-matched study

Background Transfusion management during liver transplantation (LT) is aimed at reducing blood loss and allogeneic transfusion requirements. Although prothrombin complex concentrate (PCC) has been used satisfactorily in various bleeding disorders, studies on its safety, and efficacy during LT are limited. Methods A retrospective chart review of adult patients who underwent living donor LT at a single institute between October 2016 and January 2018 was carried out. The safety and efficacy of PCC in reducing transfusion requirements intraoperatively in patients who received PCC were compared with patients who did not receive PCC. A propensity score-matching technique was used, at a 1:1 ratio, to remove selection bias. Results After completing the 1:1 propensity score-matched analysis, 60 pairs of patients were identified. The use of PCC was associated with significantly decreased red blood cell transfusion requirements (6.2 +/- 4.1 vs 8.23 +/- 5.18, P < 0.001) and fresh frozen plasma transfusion requirements (2.6 +/- 2 vs 6.18 +/- 4.1, P < 0.001). The number of patients developing postoperative hemorrhagic complications was higher in the non-PCC group. Conclusions During LT, the use of PCC led to decreased transfusion requirements. No thromboembolic complications related to PCC were noted in this series.