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 Scopus citations

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

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation'. Together they form a unique fingerprint.

  • Cite this

    Joseph, B., Aziz, H., Pandit, V., Hays, D., Kulvatunyou, N., Tang, A., Wynne, J., OKeeffe, T., Green, D. J., Friese, R. S., Gruessner, R., & Rhee, P. (2014). Prothrombin complex concentrate use in coagulopathy of lethal brain injuries increases organ donation. American Surgeon, 80(4), 335-338.