HEMOSTATIC CHANGES IN HEART TRANSPLANT RECIPIENTS AND THEIR RELATIONSHIP TO ACCELERATED CORONARY SCLEROSIS

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Abstract
Hemostasis was assessed in 115 steady-state heart transplant recipients (HTRs) and compared with that of 23 age-matched healthy controls and 21 age-matched patients with ischemic heart disease (IHD). Compared with the controls, the HTRs had increased levels of fibrinogen (mean and 95% confidence limits of 4.50 [4.32–4.68] g/L versus 3.47 [3.07–3.87] g/L, P More marked prothrombotic changes were found in HTRs transplanted for IHD than for other causes; this reached significance for prothrombin (P=0.048), factor IX (P=0.003), and poor fibrinolytic activity as measured by euglobulin clot lysis time (P=0.008). The HTRs with accelerated coronary sclerosis (ACS) tended to have the most prothrombotic changes; this reached significance with factor IX (P=0.03). In conclusion, HTRs have perturbed hemostasis; the net effects of these changes are prothrombotic. The relationship between prothrombotic changes and ACS merits further studies.

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