A Multicentre Observational Study of Prothrombin Complex Concentrate Therapy in Cardiac Surgery Patients
1
Issued Date
2026-01-01
Resource Type
ISSN
14439506
eISSN
14442892
Scopus ID
2-s2.0-105028559436
Pubmed ID
41577588
Journal Title
Heart Lung and Circulation
Rights Holder(s)
SCOPUS
Bibliographic Citation
Heart Lung and Circulation (2026)
Suggested Citation
Hikasa Y., Chaba A., Culliver C., Hasan E., Vo T.K., Yanase F., Spano S., Maeda A., Eastwood G., Kitisin N., Raykateeraroj N., Pattamin N., Phongphithakchai A., Nübel J., Caroli A., Premaratne G., Chan G., Furler J., Motley A., Hogan C., Casteden L., Anja R., Raman J., Brown A., Bellomo R. A Multicentre Observational Study of Prothrombin Complex Concentrate Therapy in Cardiac Surgery Patients. Heart Lung and Circulation (2026). doi:10.1016/j.hlc.2025.05.103 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114376
Title
A Multicentre Observational Study of Prothrombin Complex Concentrate Therapy in Cardiac Surgery Patients
Corresponding Author(s)
Other Contributor(s)
Abstract
Aim: This study aimed to assess the characteristics, transfusion events, and clinical outcomes of cardiac surgery patients treated with three-factor prothrombin complex concentrate (3F-PCC). Method: A retrospective observational study was performed in three cardiac surgery centres in Australia. We studied sequential cardiac surgeries and collected data on 3F-PCC, fresh frozen plasma (FFP) and red blood cell (RBC) use from blood banks and clinical outcomes from the Australian Society of Cardiothoracic Surgery database. We compared 3F-PCC treated to PCC-untreated patients. Results: For 1,698 patients, 254 (15%) received 3F-PCC, with a median dose of 2,000 IU (Interquartile range [IQR]: 1,000 to 2,000), administered almost exclusively in the operating theatre. After adjustment by overlap weighting, 3F-PCC was associated with a reduction in post-surgical FFP transfusions (Relative risk [RR]: 0.47; 95% confidence interval [CI] 0.29 to 0.77). Similarly, 14% of 3F-PCC patients needed ≥2 RBC units after surgery compared to 21% in controls (RR: 0.63; 95% CI 0.45 to 0.88). Both groups displayed similar safety profiles and clinical outcomes. However, pulmonary embolism occurred in 1.8% of 3F-PCC patients versus 0.8% of controls. Conclusions: In a multicentre study, 3F-PCC use during cardiac surgery was independently associated with a significantly reduction of postoperative FFP and RBC transfusions. A phase III trial of early PCC at 2,000 IU appears justified.