Background

Venous thromboembolism (VTE) is a major complication after lung transplantation (LT). However, its pathophysiology remains unknown, and coagulation profiles have yet to be described.

Objective

The aim of this study was to longitudinally assess coagulation status after LT.

Methods

We performed a prospective study and described the coagulation profiles of 48 patients at 5 different time-points: before LT and at 24–72 h, 2 weeks, 4 months, and 1 year after LT.

Results

At baseline, almost all analyzed coagulation factors were within the normal range, except for FVIII, which was above the normal range. Von Willebrand factor (vWF) and FVIII were increased after LT and remained high at 1 year after transplantation. The cumulative incidence of VTE was 22.9%. Patients who developed VTE had higher FVIII activity 2 weeks after LT.

Conclusions

This is the first study to describe coagulation profiles up to 1 year after LT. We show that most markers of a procoagulant state normalize at 2 weeks after LT, but that values of FVIII and vWF remain abnormal at 1 year. This problem has received little attention in the literature. Larger studies are necessary to confirm the results and to design appropriate prophylactic strategies.

中文翻译：

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肺移植后长期处于促凝状态吗？一项前瞻性研究

背景

静脉血栓栓塞（VTE）是肺移植（LT）后的主要并发症。然而，它的病理生理学仍然未知，凝血特征尚未描述。

客观的

本研究的目的是纵向评估 LT 后的凝血状态。

方法

我们进行了一项前瞻性研究，并描述了 48 名患者在 5 个不同时间点的凝血曲线：LT 前和 LT 后 24-72 小时、2 周、4 个月和 1 年。

结果

在基线时，几乎所有分析的凝血因子都在正常范围内，除了高于正常范围的 FVIII。Von Willebrand 因子 (vWF) 和 FVIII 在 LT 后增加，并在移植后 1 年保持高位。VTE的累积发生率为22.9%。发生 VTE 的患者在 LT 后 2 周具有更高的 FVIII 活性。

结论

这是第一项描述 LT 后长达 1 年的凝血曲线的研究。我们显示大多数促凝状态标志物在 LT 后 2 周恢复正常，但 FVIII 和 vWF 的值在 1 年时仍然异常。这个问题在文献中很少受到关注。需要更大规模的研究来确认结果并设计适当的预防策略。