Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation

Bellal Joseph, Hassan Aziz, Viraj Pandit, Daniel Hays, Narong Kulvatunyou, Andrew Tang, Julie Wynne, Terence OKeeffe, Donald J. Green, Randall S. Friese, Rainer Gruessner, Peter Rhee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Coagulopathy is a defined barrier for organ donation in patients with lethal traumatic brain injuries. The purpose of this study was to document our experience with the use of prothrombin complex concentrate (PCC) to facilitate organ donation in patients with lethal traumatic brain injuries. We performed a 4-year retrospective analysis of all patients with devastating gunshot wounds to the brain. The data were analyzed for demographics, change in international normalized ratio (INR), and subsequent organ donation. The primary end point was organ donation. Eighty-eight patients with lethal traumatic brain injury were identified from the trauma registry of whom 13 were coagulopathic at the time of admission (mean INR 2.260.8). Of these 13 patients, 10 patients received PCC in an effort to reverse their coagulopathy. Mean INR before PCC administration was 2.01 ± 0.7 and 1.1 ± 0.7 after administration (P<0.006). Correction of coagulopathy was attained in 70 per cent (seven of 10) patients. Of these seven patients, consent for donation was obtained in six patients and resulted in 19 solid organs being procured. The cost of PCC per patient was $1022 ± 544. PCC effectively reveres coagulopathy associated with lethal traumatic brain injury and enabled patients to proceed to organ donation. Although various methodologies exist for the treatment of coagulopathy to facilitate organ donation, PCC provides a rapid and cost-effective therapy for reversal of coagulopathy in patients with lethal traumatic brain injuries.

Original languageEnglish (US)
Pages (from-to)335-338
Number of pages4
JournalAmerican Surgeon
Volume80
Issue number4
StatePublished - Apr 1 2014
Externally publishedYes

Fingerprint

Tissue and Organ Procurement
Brain Injuries
International Normalized Ratio
prothrombin complex concentrates
Costs and Cost Analysis
Gunshot Wounds
Registries
Demography
Traumatic Brain Injury

ASJC Scopus subject areas

  • Surgery

Cite this

Joseph, B., Aziz, H., Pandit, V., Hays, D., Kulvatunyou, N., Tang, A., ... Rhee, P. (2014). Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation. American Surgeon, 80(4), 335-338.

Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation. / Joseph, Bellal; Aziz, Hassan; Pandit, Viraj; Hays, Daniel; Kulvatunyou, Narong; Tang, Andrew; Wynne, Julie; OKeeffe, Terence; Green, Donald J.; Friese, Randall S.; Gruessner, Rainer; Rhee, Peter.

In: American Surgeon, Vol. 80, No. 4, 01.04.2014, p. 335-338.

Research output: Contribution to journalArticle

Joseph, B, Aziz, H, Pandit, V, Hays, D, Kulvatunyou, N, Tang, A, Wynne, J, OKeeffe, T, Green, DJ, Friese, RS, Gruessner, R & Rhee, P 2014, 'Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation', American Surgeon, vol. 80, no. 4, pp. 335-338.
Joseph B, Aziz H, Pandit V, Hays D, Kulvatunyou N, Tang A et al. Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation. American Surgeon. 2014 Apr 1;80(4):335-338.
Joseph, Bellal ; Aziz, Hassan ; Pandit, Viraj ; Hays, Daniel ; Kulvatunyou, Narong ; Tang, Andrew ; Wynne, Julie ; OKeeffe, Terence ; Green, Donald J. ; Friese, Randall S. ; Gruessner, Rainer ; Rhee, Peter. / Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation. In: American Surgeon. 2014 ; Vol. 80, No. 4. pp. 335-338.
@article{8438e9e72bcc4481a0d72ac08c1819b1,
title = "Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation",
abstract = "Coagulopathy is a defined barrier for organ donation in patients with lethal traumatic brain injuries. The purpose of this study was to document our experience with the use of prothrombin complex concentrate (PCC) to facilitate organ donation in patients with lethal traumatic brain injuries. We performed a 4-year retrospective analysis of all patients with devastating gunshot wounds to the brain. The data were analyzed for demographics, change in international normalized ratio (INR), and subsequent organ donation. The primary end point was organ donation. Eighty-eight patients with lethal traumatic brain injury were identified from the trauma registry of whom 13 were coagulopathic at the time of admission (mean INR 2.260.8). Of these 13 patients, 10 patients received PCC in an effort to reverse their coagulopathy. Mean INR before PCC administration was 2.01 ± 0.7 and 1.1 ± 0.7 after administration (P<0.006). Correction of coagulopathy was attained in 70 per cent (seven of 10) patients. Of these seven patients, consent for donation was obtained in six patients and resulted in 19 solid organs being procured. The cost of PCC per patient was $1022 ± 544. PCC effectively reveres coagulopathy associated with lethal traumatic brain injury and enabled patients to proceed to organ donation. Although various methodologies exist for the treatment of coagulopathy to facilitate organ donation, PCC provides a rapid and cost-effective therapy for reversal of coagulopathy in patients with lethal traumatic brain injuries.",
author = "Bellal Joseph and Hassan Aziz and Viraj Pandit and Daniel Hays and Narong Kulvatunyou and Andrew Tang and Julie Wynne and Terence OKeeffe and Green, {Donald J.} and Friese, {Randall S.} and Rainer Gruessner and Peter Rhee",
year = "2014",
month = "4",
day = "1",
language = "English (US)",
volume = "80",
pages = "335--338",
journal = "American Surgeon",
issn = "0003-1348",
publisher = "Southeastern Surgical Congress",
number = "4",

}

TY - JOUR

T1 - Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation

AU - Joseph, Bellal

AU - Aziz, Hassan

AU - Pandit, Viraj

AU - Hays, Daniel

AU - Kulvatunyou, Narong

AU - Tang, Andrew

AU - Wynne, Julie

AU - OKeeffe, Terence

AU - Green, Donald J.

AU - Friese, Randall S.

AU - Gruessner, Rainer

AU - Rhee, Peter

PY - 2014/4/1

Y1 - 2014/4/1

N2 - Coagulopathy is a defined barrier for organ donation in patients with lethal traumatic brain injuries. The purpose of this study was to document our experience with the use of prothrombin complex concentrate (PCC) to facilitate organ donation in patients with lethal traumatic brain injuries. We performed a 4-year retrospective analysis of all patients with devastating gunshot wounds to the brain. The data were analyzed for demographics, change in international normalized ratio (INR), and subsequent organ donation. The primary end point was organ donation. Eighty-eight patients with lethal traumatic brain injury were identified from the trauma registry of whom 13 were coagulopathic at the time of admission (mean INR 2.260.8). Of these 13 patients, 10 patients received PCC in an effort to reverse their coagulopathy. Mean INR before PCC administration was 2.01 ± 0.7 and 1.1 ± 0.7 after administration (P<0.006). Correction of coagulopathy was attained in 70 per cent (seven of 10) patients. Of these seven patients, consent for donation was obtained in six patients and resulted in 19 solid organs being procured. The cost of PCC per patient was $1022 ± 544. PCC effectively reveres coagulopathy associated with lethal traumatic brain injury and enabled patients to proceed to organ donation. Although various methodologies exist for the treatment of coagulopathy to facilitate organ donation, PCC provides a rapid and cost-effective therapy for reversal of coagulopathy in patients with lethal traumatic brain injuries.

AB - Coagulopathy is a defined barrier for organ donation in patients with lethal traumatic brain injuries. The purpose of this study was to document our experience with the use of prothrombin complex concentrate (PCC) to facilitate organ donation in patients with lethal traumatic brain injuries. We performed a 4-year retrospective analysis of all patients with devastating gunshot wounds to the brain. The data were analyzed for demographics, change in international normalized ratio (INR), and subsequent organ donation. The primary end point was organ donation. Eighty-eight patients with lethal traumatic brain injury were identified from the trauma registry of whom 13 were coagulopathic at the time of admission (mean INR 2.260.8). Of these 13 patients, 10 patients received PCC in an effort to reverse their coagulopathy. Mean INR before PCC administration was 2.01 ± 0.7 and 1.1 ± 0.7 after administration (P<0.006). Correction of coagulopathy was attained in 70 per cent (seven of 10) patients. Of these seven patients, consent for donation was obtained in six patients and resulted in 19 solid organs being procured. The cost of PCC per patient was $1022 ± 544. PCC effectively reveres coagulopathy associated with lethal traumatic brain injury and enabled patients to proceed to organ donation. Although various methodologies exist for the treatment of coagulopathy to facilitate organ donation, PCC provides a rapid and cost-effective therapy for reversal of coagulopathy in patients with lethal traumatic brain injuries.

UR - http://www.scopus.com/inward/record.url?scp=84904353412&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904353412&partnerID=8YFLogxK

M3 - Article

VL - 80

SP - 335

EP - 338

JO - American Surgeon

JF - American Surgeon

SN - 0003-1348

IS - 4

ER -