International survey on anticoagulation and antiplatelet strategies after pediatric liver transplantation
In pediatric LT, anticoagulants and antiplatelet agents are regularly used to reduce the risk of vascular thrombosis. As evidence for optimal strategy is lacking, local practices vary greatly. The present survey aimed to compile an international overview of anticoagulation and antiplatelet strategie...
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| Veröffentlicht in: | Pediatric transplantation 2019-02, Vol.23 (1), p.e13317-n/a |
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| creator | Calinescu, Ana M. Karam, Oliver Wilde, Jim C. H. Ansari, Marc McLin, Valerie A. Wildhaber, Barbara E. |
| description | In pediatric LT, anticoagulants and antiplatelet agents are regularly used to reduce the risk of vascular thrombosis. As evidence for optimal strategy is lacking, local practices vary greatly. The present survey aimed to compile an international overview of anticoagulation and antiplatelet strategies in pediatric LT. An online survey was sent to 98 pediatric LT centers in North and South America, Europe, Asia, and Australia. Twenty‐four centers answered the survey. 20/24 (83%) use some sort of anticoagulation and antiplatelet therapy, yielding 20 different strategies. Perioperative vascular problems, size of the hepatic artery, and patient weight were the most frequent determinants of changes in anticoagulant and antiplatelet strategy. Early HAT rates were reported to be 5% or less in 79% of responding centers. Anticoagulation and antiplatelet strategies were not significantly associated with early HAT rates (P = 0.63), or with the number of pediatric LTs performed per year and center (P = 0.92). Internationally, there is a wide variety in anticoagulation and antiplatelet strategies after pediatric LT. Efforts must be made to design a prospective multicentric trial to identify the optimal antithrombotic strategy. |
| doi_str_mv | 10.1111/petr.13317 |
| format | Article |
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H. ; Ansari, Marc ; McLin, Valerie A. ; Wildhaber, Barbara E.</creator><creatorcontrib>Calinescu, Ana M. ; Karam, Oliver ; Wilde, Jim C. H. ; Ansari, Marc ; McLin, Valerie A. ; Wildhaber, Barbara E.</creatorcontrib><description>In pediatric LT, anticoagulants and antiplatelet agents are regularly used to reduce the risk of vascular thrombosis. As evidence for optimal strategy is lacking, local practices vary greatly. The present survey aimed to compile an international overview of anticoagulation and antiplatelet strategies in pediatric LT. An online survey was sent to 98 pediatric LT centers in North and South America, Europe, Asia, and Australia. Twenty‐four centers answered the survey. 20/24 (83%) use some sort of anticoagulation and antiplatelet therapy, yielding 20 different strategies. Perioperative vascular problems, size of the hepatic artery, and patient weight were the most frequent determinants of changes in anticoagulant and antiplatelet strategy. Early HAT rates were reported to be 5% or less in 79% of responding centers. Anticoagulation and antiplatelet strategies were not significantly associated with early HAT rates (P = 0.63), or with the number of pediatric LTs performed per year and center (P = 0.92). Internationally, there is a wide variety in anticoagulation and antiplatelet strategies after pediatric LT. Efforts must be made to design a prospective multicentric trial to identify the optimal antithrombotic strategy.</description><identifier>ISSN: 1397-3142</identifier><identifier>EISSN: 1399-3046</identifier><identifier>DOI: 10.1111/petr.13317</identifier><identifier>PMID: 30393923</identifier><language>eng</language><publisher>Denmark: Wiley Subscription Services, Inc</publisher><subject>Anticoagulants ; Anticoagulants - therapeutic use ; anticoagulation ; Antiplatelet therapy ; Child ; Drug Administration Schedule ; Health Care Surveys ; Hepatic Artery ; hepatic artery thrombosis ; Humans ; Liver Transplantation ; Liver transplants ; pediatric liver transplantation ; Pediatrics ; Platelet Aggregation Inhibitors - therapeutic use ; Postoperative Complications - prevention & control ; Practice Patterns, Physicians' - statistics & numerical data ; Thrombosis ; Thrombosis - etiology ; Thrombosis - prevention & control ; Treatment Outcome</subject><ispartof>Pediatric transplantation, 2019-02, Vol.23 (1), p.e13317-n/a</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><rights>2019 John Wiley & Sons A/S. 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H.</creatorcontrib><creatorcontrib>Ansari, Marc</creatorcontrib><creatorcontrib>McLin, Valerie A.</creatorcontrib><creatorcontrib>Wildhaber, Barbara E.</creatorcontrib><title>International survey on anticoagulation and antiplatelet strategies after pediatric liver transplantation</title><title>Pediatric transplantation</title><addtitle>Pediatr Transplant</addtitle><description>In pediatric LT, anticoagulants and antiplatelet agents are regularly used to reduce the risk of vascular thrombosis. As evidence for optimal strategy is lacking, local practices vary greatly. The present survey aimed to compile an international overview of anticoagulation and antiplatelet strategies in pediatric LT. An online survey was sent to 98 pediatric LT centers in North and South America, Europe, Asia, and Australia. Twenty‐four centers answered the survey. 20/24 (83%) use some sort of anticoagulation and antiplatelet therapy, yielding 20 different strategies. Perioperative vascular problems, size of the hepatic artery, and patient weight were the most frequent determinants of changes in anticoagulant and antiplatelet strategy. Early HAT rates were reported to be 5% or less in 79% of responding centers. Anticoagulation and antiplatelet strategies were not significantly associated with early HAT rates (P = 0.63), or with the number of pediatric LTs performed per year and center (P = 0.92). Internationally, there is a wide variety in anticoagulation and antiplatelet strategies after pediatric LT. Efforts must be made to design a prospective multicentric trial to identify the optimal antithrombotic strategy.</description><subject>Anticoagulants</subject><subject>Anticoagulants - therapeutic use</subject><subject>anticoagulation</subject><subject>Antiplatelet therapy</subject><subject>Child</subject><subject>Drug Administration Schedule</subject><subject>Health Care Surveys</subject><subject>Hepatic Artery</subject><subject>hepatic artery thrombosis</subject><subject>Humans</subject><subject>Liver Transplantation</subject><subject>Liver transplants</subject><subject>pediatric liver transplantation</subject><subject>Pediatrics</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Postoperative Complications - prevention & control</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Thrombosis</subject><subject>Thrombosis - etiology</subject><subject>Thrombosis - prevention & control</subject><subject>Treatment Outcome</subject><issn>1397-3142</issn><issn>1399-3046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFLwzAUxoMobk4v_gFS8CJCZ9KkTXOUMXUwUGSeS5q-joyurUk62X9v1k4PHswl73vvx8fjfQhdEzwl_j204MyUUEr4CRoTKkRIMUtO-5qHlLBohC6s3WBMEpayczSimAoqIjpGelE7MLV0uqllFdjO7GAfNHUga6dVI9dd1c-8Lvpe6zVU4ALrjK_WGmwgS-8RtFBo6YxWQaV3Xvt5bT1eu97hEp2VsrJwdfwn6ONpvpq9hMvX58XscRkqvxMPkwR4BAIkMIVjASKBKOZK5YpHuVIk5gKnokiVJ3IecyYKQsu4SFhUMFxwOkF3g29rms8OrMu22iqo_CLQdDaLCMU4TjFJPXr7B900nT9GdaA4pRFnOPHU_UAp01hroMxao7fS7DOCs0MA2SGArA_AwzdHyy7fQvGL_lzcA2QAvnQF-3-ssrf56n0w_QZsh5MJ</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Calinescu, Ana M.</creator><creator>Karam, Oliver</creator><creator>Wilde, Jim C. 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H.</creatorcontrib><creatorcontrib>Ansari, Marc</creatorcontrib><creatorcontrib>McLin, Valerie A.</creatorcontrib><creatorcontrib>Wildhaber, Barbara E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Calinescu, Ana M.</au><au>Karam, Oliver</au><au>Wilde, Jim C. H.</au><au>Ansari, Marc</au><au>McLin, Valerie A.</au><au>Wildhaber, Barbara E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>International survey on anticoagulation and antiplatelet strategies after pediatric liver transplantation</atitle><jtitle>Pediatric transplantation</jtitle><addtitle>Pediatr Transplant</addtitle><date>2019-02</date><risdate>2019</risdate><volume>23</volume><issue>1</issue><spage>e13317</spage><epage>n/a</epage><pages>e13317-n/a</pages><issn>1397-3142</issn><eissn>1399-3046</eissn><abstract>In pediatric LT, anticoagulants and antiplatelet agents are regularly used to reduce the risk of vascular thrombosis. As evidence for optimal strategy is lacking, local practices vary greatly. The present survey aimed to compile an international overview of anticoagulation and antiplatelet strategies in pediatric LT. An online survey was sent to 98 pediatric LT centers in North and South America, Europe, Asia, and Australia. Twenty‐four centers answered the survey. 20/24 (83%) use some sort of anticoagulation and antiplatelet therapy, yielding 20 different strategies. Perioperative vascular problems, size of the hepatic artery, and patient weight were the most frequent determinants of changes in anticoagulant and antiplatelet strategy. Early HAT rates were reported to be 5% or less in 79% of responding centers. Anticoagulation and antiplatelet strategies were not significantly associated with early HAT rates (P = 0.63), or with the number of pediatric LTs performed per year and center (P = 0.92). Internationally, there is a wide variety in anticoagulation and antiplatelet strategies after pediatric LT. 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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Anticoagulants Anticoagulants - therapeutic use anticoagulation Antiplatelet therapy Child Drug Administration Schedule Health Care Surveys Hepatic Artery hepatic artery thrombosis Humans Liver Transplantation Liver transplants pediatric liver transplantation Pediatrics Platelet Aggregation Inhibitors - therapeutic use Postoperative Complications - prevention & control Practice Patterns, Physicians' - statistics & numerical data Thrombosis Thrombosis - etiology Thrombosis - prevention & control Treatment Outcome |
| title | International survey on anticoagulation and antiplatelet strategies after pediatric liver transplantation |
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