Superior efficacy and reduced transfusions with 4F-PCC vs. FP in cardiac surgery: LEX-211 (FARES-II)

Jeannie Callum, M.D.
Kingston Health Sciences Centre and Queen's University
Kingston, Ontario, Canada

Cardiac surgery with cardiopulmonary bypass can lead to coagulopathic bleeding that requires urgent treatment. One of the causes of bleeding after cardiac surgery is a drop in thrombin generation. In this presentation, Jeannie Callum presents findings from the LEX-211 (FARES-II) trial, which compared the efficacy and safety of 2000 IU of 4-factor prothrombin complex concentrate (4F-PCC) versus 4 units of frozen plasma (FP). The study included 420 patients and assessed hemostatic effectiveness and transfusion needs. Results showed that 4F-PCC was more efficacious than FP for managing coagulopathic bleeding in cardiac surgery, and with an improved safety profile (reduced serious adverse events, including kidney failure).