The Effect of Desmopressin on the Amount of Bleeding and Transfusion Requirements in Patients undergoing Heart Transplant Surgery.

Basic & Clinical Pharmacology & Toxicology 2017; 22: 22.

Aims
To investigate the effectiveness of desmopressin on the amount of bleeding and transfusion requirements in patients undergoing heart transplant surgery.

Interventions
Participants were randomised to receive either desmopressin 0.3 μg/kg, 30 minutes before surgery, versus a normal saline.

Participants
48 patients scheduled to undergo heart transplantation, aged between 20-70 years.

Outcomes
Primary measured outcomes included haemostasis, chest tube drainages, hemoglobin and hematocrit levels, transfusion requirements, coagulation laboratory tests and mandatory reoperation. Secondary measured outcomes included age, gender, body mass index, underlying diseases, operating time, cardiopulmonary bypass length, intraoperative colloids, intravenous inotropic therapy, inotrope score, urinary output, duration of mechanical ventilation, length of hospitalization in ICU and potential thrombotic events.

Follow-up
24 hours after surgery

CET Conclusions
This is a small double-blinded trial in 48 patients who are awaiting a heart transplant and were randomly assigned either to receive Desmopressin before surgery or saline in the control group. Haemostasis was evaluated using several established assays performed 12 and 24 hours after surgery but also the authors measured chest tube drainage and the requirements for blood transfusion during the first day. No differences were found in the groups in terms of measurement of haemostasis but transfusion of packed red blood cells and the mean drainages of the chest tube during the first 24 hours after surgery were significantly lower in the Desmopressin group. Thus, Desmopressin may reduce postoperative bleeding in patients undergoing heart transplant surgery but larger studies including coagulation studies would be required to demonstrate this potentially beneficial effect of Desmopressin.

Jadad score
4

Data analysis
Per protocol analysis

Allocation concealment
Yes

Trial registration
None

Funding source
Not reported