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February 5, 2026Liver TransplantationOpen Access

A pilot, two-centre, sequential dose escalation safety study of alteplase with fresh frozen plasma during normothermic liver perfusion

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Authors

CWC. J.E. WatsonSMStephen MacDonaldDWDanielle White

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Overview

Pilot study reveals no increased bleeding with alteplase and fresh frozen plasma in liver transplantation, suggesting safety for further research.

Key Points

  • This research aims to evaluate the safety of using alteplase and fresh frozen plasma during liver perfusion to prevent complications.
  • Conducted a pilot, two-centre, dose escalation study with 80 randomized donor livers.
  • Livers were treated with either 10 mg or 20 mg alteplase alongside varying units of fresh frozen plasma.
  • Assessed fibrin breakdown via D-dimer release and monitored bleeding post-transplant.
  • No increase in post-implant bleeding or blood transfusion requirements in alteplase-treated livers compared to controls.
  • All alteplase groups showed significantly more D-dimer release than controls.
  • The most effective protocol involved 10 mg alteplase with 2 units of fresh frozen plasma delivered directly into the portal reservoir.

Cite This Study

Watson et al. (2026) studied this question.

synapsesocial.com/papers/69843564f1d9ada3c1fb42e3https://doi.org/10.1097/lvt.0000000000000814
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Treating Donation After Circulatory Death Liver Grafts With Alteplase During Ex Situ Normothermic Machine Perfusion2025
  2. 2ALTEPLASE AND METHYLPREDNISOLONE ASSOCIATED TREATMENT MODULATE MICROCIRCULATION AND INFLAMMATION ON BRAIN DEATH DONORS2026
  3. 3Reduction in Red Blood Cell Lysis by Polymer Intervention During Rodent Liver Normothermic Machine Perfusion2026
  4. 4The effects of double-filtration plasmapheresis on coagulation profiles and the risk of bleeding2024 · 5 citations
  5. 5A-154 Non-standard body fluid validation of d-dimer analysis of organox liver perfusate to support clinical evaluations of donor livers prior to transplantation2024