Primary Article

Effectiveness of Conjugated Estrogen in Orthotopic Liver Transplantation

Authors: LUC FRENETTE MD, JERRY COX MD, MARK ARNALL MD, DEVIN ECKHOFF MD, STEVE BYNON MD

Abstract

ABSTRACT Background.A retrospective study was conducted at a university hospital to determine the efficacy of conjugated estrogen in reducing blood product transfusion during orthotopic liver transplantation. Methods.The charts of patients who had orthotopic liver transplantation were retrospectively reviewed. Only those having a reaction time > 30 mm or 15 minutes (normal = 19 mm to 28 mm) on computerized thromboelastogram (CTEG) at the beginning of surgery were included. One group of patients received a first dose of conjugated estrogen (100 mg IV) at the beginning of the case and a second dose (100 mg IV) just after reperfusion of the new graft. The control group did not receive estrogen. The two groups were similar in age, weight, first TEG measurements, final intraoperative hemoglobin concentration and platelet count. Blood products were given in response to hematocrit and CTEG measurements, which were determined every hour during surgery. Results.The two groups did not differ in units of cryoprecipitate and platelets administered, but the intraoperative requirements for red blood cells and fresh frozen plasma were significantly lower in the estrogen group than in the control group. Conclusion.Administration of conjugated estrogen is associated with a statistically significant decrease in use of red blood cells and fresh frozen plasma during orthotopic liver transplantation.

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References