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Use of Idarucizumab to reverse the anticoagulant effect of dabigatran in cardiac transplant surgery. A multicentric experience in Spain.
- Source :
-
Clinical Transplantation . Dec2019, Vol. 33 Issue 12, pN.PAG-N.PAG. 1p. - Publication Year :
- 2019
-
Abstract
- Background: Anticoagulation in heart transplant (HT) recipients increases the risk of hemorrhagic complications, so correct reversal of anticoagulation is needed. Dabigatran, a direct thrombin inhibitor, is increasingly used for anticoagulation in patients with non‐valvular atrial fibrillation (NVAF) whose effect can be reversed by idarucizumab. Aim: To present a nationwide experience using idarucizumab for the urgent reversal of dabigatran before HT. Methods: Multicenter observational study in 12 Spanish centers to analyze the clinical outcomes after using idarucizumab before HT surgery. Results: Fifty‐three patients were included (81.1% male). 7.5% required re‐operation in the immediate postoperative period to control bleeding and 66% transfusion of blood products. Median length of stay in the intensive care unit was 6 days and total hospital stay 24 days. 30‐day survival was 92.4%. There were four deaths in the first month, all in the first 5 days post‐HT. Only in one patient (transplanted due to a congenital heart disease, after sternotomy) who had surgical problems and right ventricular failure post‐HT death was associated with bleeding. Conclusions: These results may support the use of dabigatran as an alternative to vitamin K antagonists in patients listed for HT requiring anticoagulation due to NVAF. More studies are needed to reaffirm these observations. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09020063
- Volume :
- 33
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Clinical Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 140852642
- Full Text :
- https://doi.org/10.1111/ctr.13748