Hepatic artery thrombosis (HAT) represents a major cause of graft loss and mortality after Pediatric liver transplantation. Ticagrelor (a new reversible inhibitor of P2Y12 receptor with faster onset of action and greater platelet inhibition) was used to treat patients with pediatric post-transplant hepatic artery thrombosis (HAT) compared to low molecular weight heparin.
In pediatric patients with post-transplant hepatic artery thrombosis (HAT) , low molecular weight heparin is a commonly used method. Ticagrelor, a direct-acting and reversible ADP receptor antagonist, is now the most commonly used ADP receptor antagonist in the treatment of coronary diseases. Compared to its predecessor clopidogrel, the pharmacokinetic profil of ticagrelor is more predictable, demonstrating a faster onset of action and a more consistent platelet inhibition. However, because of the excellent antithrombotic effect and increased bleeding potential, it is recommended that major bleeding, such as OPCAB or CABG surgery, be expected with a high probability, and in case of fatal surgery, the drug should be discontinued for 5 days. The present study is to evaluate the safety and efficacy of Ticagrelor in pediatirc receipt with post-operative HAT.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Ticagrelor, 2-3mg/kg, 12h, p.o.
half amount low molecular weight heparin
Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University
Shanghai, China
Contrast-Enhanced Ultrasonography-Based Hepatic Perfusion Index
The peak systolic maximum velocity (Vmax) of the HA, and HA resistive index (HARI)
Time frame: 3 months
High on-treatment platelet reactivity (HPR)
HPR defined as platelet reactivity index (PRI) ≥50% using VASP analysis
Time frame: Two hours after the injection of either active drug or placebo
Post-operative major bleeding event
post-operative major bleeding defined as HAT related bleeding
Time frame: within 72 hours after operation
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