Epsilon-Aminocaproic Acid Has No Association With Thromboembolic Complications, Renal Failure, or Mortality After Liver Transplantation

J Cardiothorac Vasc Anesth. 2016 Aug;30(4):917-23. doi: 10.1053/j.jvca.2015.12.003. Epub 2015 Dec 3.


Objectives: To examine the role of epsilon-aminocaproic acid (EACA) administered after reperfusion of the donor liver in the incidences of thromboembolic events and acute kidney injury within 30 days after orthotopic liver transplantation. One-year survival rates between the EACA-treated and EACA-nontreated groups also were examined.

Design: Retrospective, observational, cohort study design.

Setting: Single-center, university hospital.

Participants: The study included 708 adult liver transplantations performed from 2008 to 2013.

Interventions: None.

Measurements and main results: EACA administration was not associated with incidences of intracardiac thrombosis/pulmonary embolism (1.3%) or intraoperative death (0.6%). Logistic regression (n = 708) revealed 2 independent risk factors associated with myocardial ischemia (age and pre-transplant vasopressor use) and 8 risk factors associated with the need for post-transplant dialysis (age, female sex, redo orthotopic liver transplantation, preoperative sodium level, pre-transplant acute kidney injury or dialysis, platelet transfusion, and re-exploration within the first week after transplant); EACA was not identified as a risk factor for either outcome. One-year survival rates were similar between groups: 92% in EACA-treated group versus 93% in the EACA-nontreated group.

Conclusions: The antifibrinolytic, EACA, was not associated with an increased incidence of thromboembolic complications or postoperative acute kidney injury, and it did not alter 1-year survival after liver transplantation.

Keywords: acute kidney injury; antifibrinolytics; epsilon-aminocaproic acid; intracardiac thrombosis/pulmonary embolism; liver transplantation; thromboembolic complications.

Publication types

  • Observational Study

MeSH terms

  • Acute Kidney Injury / etiology*
  • Aminocaproic Acid / administration & dosage
  • Aminocaproic Acid / adverse effects*
  • Antifibrinolytic Agents / administration & dosage
  • Antifibrinolytic Agents / adverse effects*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / mortality
  • Male
  • Middle Aged
  • Renal Replacement Therapy
  • Retrospective Studies
  • Risk Factors
  • Survival Analysis
  • Thromboembolism / etiology*


  • Antifibrinolytic Agents
  • Aminocaproic Acid