The requirement of transfusion and postoperative outcomes in OLT:a meta-analysis on aprotinin

Objective To study the effect of aprotinin used in orthotopic liver transplantation(OLT) on the intraoperative requirement of blood products and on the incidence of laparotomy for bleeding,thromboembolic events and mortality.Methods A systematic review of the literatures was performed in the electronic database of Medline.Citations that do not fit our study were excluded.The citations were unscrambled and the data were recorded.Weighted mean differences(WMD) of the data on the requirements of blood products were tested using the fixed effect model.Z test was performed to examine their reliability and Fleiss method of fixed effect model was used to analyze the data on postoperative events,and their odds ratio(ORi) was tested and merged as well.Results seven citations were involved in this study.Among them,the requirement of blood products was reported in 4 studies of 321 patients,while the postoperative events were reported in 5 studies of 477 patients.The effect of aprotinin on the requirement of red blood cell and fresh frozen plasma was statistically significant(WMD=-1.80 units,95%CI,-3.38 to -0.22;WMD=-3.99units,95%CI,-6.47 to -1.50,respectively).However,no significant difference was indicated on the incidence of laparotomy for bleeding,thromboembolic events,and mortality between the two groups.Conclusion Aprotinin can reduce the intraoperative requirement of blood products in OLT,and has no significant effect on the incidence of laparotomy for bleeding,thromboembolic events,and mortality.