Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 24, 2015; 5(4): 320-328
Published online Dec 24, 2015. doi: 10.5500/wjt.v5.i4.320
Perioperative effects of high doses of intraoperative thymoglobulin induction in liver transplantation
Lesley De Pietri, Valentina Serra, Giuseppe Preziosi, Gianluca Rompianesi, Bruno Begliomini
Lesley De Pietri, Bruno Begliomini, Division of Anaesthesiology and Intensive Care Unit, Azienda Ospedaliero-Universitaria di Modena-Policlinico, 41100 Modena, Italy
Valentina Serra, Gianluca Rompianesi, Liver and Multivisceral Transplant Centre, Azienda Ospedaliero-Universitaria di Modena-Policlinico, 41100 Modena, Italy
Giuseppe Preziosi, Division of General Surgery, University College London, London NW3 2QG, United Kingdom
Author contributions: De Pietri L conceived and designed the research study, wrote and revised the manuscript; Serra V revised the manuscript; Preziosi G revised the manuscript; Rompianesi G performed the research; Begliomini B revised the manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Azienda Ospedaliera-Universitaria, Modena (23/09) and was conducted in accordance with provisions of the Declaration of Helsinki and Good Clinical Practice guidelines.
Informed consent statement: All patients, or their legal guardian, provided a written informed consent prior to study enrolment.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Lesley De Pietri, Division of Anaesthesiology and Intensive Care Unit, Azienda Ospedaliero- Universitaria di Modena-Policlinico, # 71 via del Pozzo, 41100 Modena, Italy. lesley.depietri@yahoo.it
Telephone: +39-059-4225684 Fax: +39-059-4224100
Received: June 26, 2015
Peer-review started: June 28, 2015
First decision: August 26, 2015
Revised: October 6, 2015
Accepted: November 23, 2015
Article in press: November 25, 2015
Published online: December 24, 2015
Core Tip

Core tip: The optimal management, in terms of dosing and timing of thymoglobulin® [antithymocyte globulin (ATG)] administration, during liver transplantation (LT) remains controversial. Several adverse effects associated with ATG infusion have been described, but the perioperative effects of ATG administration, with particular regard to coagulation and haemodynamic consequences, in patients who received a LT have never been described. Perioperative ATG administration was associated with a significantly longer surgical procedure, higher core temperature, blood loss, blood product transfusion, a higher requirement for catecholamines and continuous renal replacement therapy. The side effects and the coagulation imbalance observed in patients receiving a high dosage of ATG suggest caution in the use of thymoglobulin during LT.