A Multicentre Observational Study of Prothrombin Complex Concentrate Therapy in Cardiac Surgery Patients - 06/03/26
, Christine Culliver, BSc c, Emel Hasan, BSc c, Thien-Kim Vo, MD d, Fumitaka Yanase, MD, PhD b, d, Sofia Spano, MD a, Akinori Maeda, MD a, Glenn Eastwood, PhD a, Nuanprae Kitisin, MD a, e, Nattaya Raykateeraroj, MD a, e, Nuttapol Pattamin, MD a, Atthaphong Phongphithakchai, MD a, Jonathan Nübel, MD a, f, Alessandro Caroli, MD a, Gehan Premaratne, MD a, g, Gabriel Chan a, g, Joseph Furler a, g, Andrew Motley, PGCipN h, Christopher Hogan, MD h, Laura Casteden, MD i, Rafaela Anja, PhD i, Jai Raman, MD i, Alastair Brown, MD d, Rinaldo Bellomo, MD, PhD a, b, g, jAbstract |
Aim |
This study aimed to assess the characteristics, transfusion events, and clinical outcomes of cardiac surgery patients treated with three-factor prothrombin complex concentrate (3F-PCC).
Method |
A retrospective observational study was performed in three cardiac surgery centres in Australia. We studied sequential cardiac surgeries and collected data on 3F-PCC, fresh frozen plasma (FFP) and red blood cell (RBC) use from blood banks and clinical outcomes from the Australian Society of Cardiothoracic Surgery database. We compared 3F-PCC treated to PCC-untreated patients.
Results |
For 1,698 patients, 254 (15%) received 3F-PCC, with a median dose of 2,000 IU (Interquartile range [IQR]: 1,000 to 2,000), administered almost exclusively in the operating theatre. After adjustment by overlap weighting, 3F-PCC was associated with a reduction in post-surgical FFP transfusions (Relative risk [RR]: 0.47; 95% confidence interval [CI] 0.29 to 0.77). Similarly, 14% of 3F-PCC patients needed ≥2 RBC units after surgery compared to 21% in controls (RR: 0.63; 95% CI 0.45 to 0.88). Both groups displayed similar safety profiles and clinical outcomes. However, pulmonary embolism occurred in 1.8% of 3F-PCC patients versus 0.8% of controls.
Conclusions |
In a multicentre study, 3F-PCC use during cardiac surgery was independently associated with a significantly reduction of postoperative FFP and RBC transfusions. A phase III trial of early PCC at 2,000 IU appears justified.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Bleeding, Cardiac surgery, Fresh frozen plasma, Red blood cells, Transfusion, Prothrombin complex concentrate
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Vol 35 - N° 3
P. 409-418 - marzo 2026 Ritorno al numero
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