Clinical study of argatroban for preventing vascular thrombosis in the early period after pediatric living related liver transplantation

Abstract

Objective To evaluate the effect of heparin and argatroban on the coagulating function and the vascular thrombosis in the early period after pediatric living related liver transplantation (LRLT). Method Eighty-four congenital biliary atresia pediatric patients who had performed LRLT were involved in this study. According to the method of anticoagulation, the patients were divided into two groups (heparin group and argatroban group). Antithrombin Ⅲ (AT-Ⅲ) activity, activated partial thromboplastin time (APTT) and international normalized ratio (INR) of two groups were measured in the first 5 days after LRLT. In order to determine whether vascular thrombosis existed, Doppler ultrasound was performed daily. Result There were no significant differences in gender, age, body weight, graft-recipient weight ratio and whether to accept Kassi procedure between two groups. The AT-Ⅲ activity of two groups was low and increased gradually after operation. There was no significant difference between two groups. There were no significant differences in APTT and INR between two groups immediate and at first day after operation. After anticoagulation, the differences in APTT and INR between two groups were significant. The incidence of vascular thrombosis was 4.76% (3/63) and 0(0/21) respectively in heparin and argatroban groups. There was no significant difference between two groups. During treatment, there were no severe complications in two groups, such as active hemorrhage and allergy. Conclusion Argatroban is a direct anticoagulant. It is independent on the level of AT-Ⅲ activity. It may play an important role for preventing vascular thrombosis after pediatric LRLT. Key words: Pediatric; Liver transplantation; Thrombus complication; Argatroban