Prognostic value of the activated partial thromboplastin time after orthotopic liver transplantation

Summary In this prospective study, we evaluated the predictive value of activated partial thromboplastin time on day 8 post transplantation for event-free survival in patients who had had orthotopic liver transplants; both death and retransplantation within 6 months were the events considered. In a 4-year period, 109 patients had orthotopic liver transplants in our hospital, and 104 were eligible for the study since they survived and were not given new transplants within 8 days. The activated partial thromboplastin time was significantly longer in patients who survived event-free for less than 6 months than in those with longer event-free survivals. Kaplan-Meier curves showed that patients with normal activated partial thromboplastin times were nine times more likely to survive more than 6 months without events than patients with prolonged values. The positive predictive value of activated partial thromboplastin time for event-free survival was 88% and the negative predictive value was 54%, indicating that the test is useful for predicting patient outcome. We suggest that activated partial thromboplastin time be performed on day 8 post transplantation to predict the medium-term event-free survival.