Results
From September 2020 through December 2022, 19 patients, median age 13.5
years (6.1, 15.8 years), weighing 48.9 kg (15.4, 67.6) received apixaban
while awaiting transplant. Indication for apixaban was prophylaxis
(n=18, 3 with ventricular assist devices) and treatment of thrombus
(n=1). There were no clinically relevant non-major or major bleeding,
nor thrombotic events while awaiting transplant. The median time from
last apixaban dose to arrival in the operating room was 23.2 hours
(15.6-33.8), with median random apixaban level of 37 ng/ml (28.3, 59),
6.3 hours (4.8, 8.4) prior to arrival in the operating room. 32% of
patients had significant post-operative bleeding based on chest tube
output post-transplant or need for intervention. No patients meeting
criteria for significant postoperative bleeding were thought to be
attributable to apixaban.