Zastosowanie koncentratu czynników zespołu protrombiny w leczeniu zaburzeń hemostazy osoczowej po operacji transplantacji serca

Hemostasis involves complex processes meaning blood not to extravasate. It's temporary cessation is necessary to perform cardiac surgery procedure with cardiopulmonary bypass. In heart transplantation, standard procedures of heparine neutralization are insufficient. We present results obtained from the group of 10 patients (8 men and 2 women) in mean age of 41 ± 15 years, who underwent heart transplantation procedure with Lower-Shumway technique in moderate hypothermia (28°C). Mean cardiopulmonary bypass time was 218 ± 20 min, cross clampling aortic time was 114 ± 18 min and organ cold ischemia time was 221 ± 16 min. Postoperative human prothrombin complex was given after INR result (2.2 ± 0.3) was obtained followed by normalized activated clotting time (ACT) 124 ± 17 seconds. In high risk patients undergoing cardiac surgery procedure, standard international normalized ration (INR) measurements following ACT results are required to obtain more detailed information concerning plasma hemostasis disturbances. Prothromplex Total NF (Baxter International Inc, USA) is a safe option to correct the problem without risk of overloading the patients circulatory system.