A prospective, randomized, pilot trial of a polyethylene glycol (PEG)-coated collagen patch (Hemopatch®) for intraoperative hemostasis during deceased donor renal transplant

Abstract

Introduction: The objective of this study was to evaluate the safety and feasibility of using a polyethylene glycol (PEG)-coated collagen patch (Hemopatch®) in patients undergoing deceased donor renal transplant. The primary outcome was the amount of intraoperative estimated blood loss in those patients receiving the patch compared to without. Secondary outcomes were the subjective achievement of hemostasis, perigraft collection, and drop in hemoglobin 48 hours postoperatively.
 Methods: We performed a single-center, prospective, randomized trial. Patients scheduled to undergo deceased donor renal transplant surgery were randomized to receive the PEG-coated patch or standard hemostasis (i.e., electrocautery and clips).
 Results: A total of 30 patients were enrolled over 15 months and randomized to receive the PEG-coated patch (n=15) or standard hemostasis (n=15). The mean age was 62.5 years. As determined by the operating surgeon, hemostasis was successfully achieved in all 15 cases using the PEG-coated patch. In the PEG-coated patch group, there was a trend towards less estimated blood loss (237 cc vs. 327 cc; p=0.11) and a lower drop in hemoglobin 48 hours postoperatively (22.27 g/L vs. 29.53 g/L; p=0.09) compared to the standard hemostasis group. Perigraft collection was similar between groups (27% vs. 40%; p=0.43). Subgroup analysis on patients who received anticoagulation therapy revealed no significant difference in blood loss between groups.
 Conclusions: Based on our single-center experience, the PEG-coated patch (Hemopatch®) is a safe and feasible option to aid hemostasis during deceased donor renal transplant surgery. Hemostasis was successfully achieved in all cases using the PEG-coated patch.

Evaluating HEmopatch® in Reducing Seroma-Related Complications following Axillary Lymph Node DIssection: A Pilot Study (HEIDI)

“…The number of SSIs in the Hemopatch® group is consistent with previously reported rates of 9–15% after ALND [20, 21]. Additionally, a number of studies on the use of Hemopatch® for a variety of indications did not show an increased risk for infections [22, 23]. Another study on the use of Hemopatch® as a dural sealant reported an SSI rate of 4.5% compared to 1.0–5.6% after dural closure without Hemopatch® [24].…”

Responsive Hydrogels Based on Triggered Click Reactions for Liver Cancer

“…Based on current clinical experience, PEG hydrogel is a safe and feasible option to aid hemostasis during surgery, and hemostasis has been successfully achieved in deceased donor kidney transplantation with the assistance of PEG hydrogel. [ 59 ] The other most commonly used synthetic hydrogel called coseal is currently used as a sealant around suture sites which consists of a four‐armed PEG succinimide‐activated ester and a four‐armed PEG thiol. However, since the thiol groups on the structure of the coseal sealant are easily oxidized, special handling is required for use, which greatly increases the cost of use.…”

PEG-coated patch parenchymal closure technique and initial outcomes during minimally invasive partial nephrectomy

“…The use of this PEG-coated patch for hemostasis has been described across a number of surgical disciplines for both open and laparoscopic procedures. 7,8 One area of concern in laparoscopy is unintentionally activating the PEG-layer on adjacent tissue or blood while positioning the patch, which may complicate the ease of use of this patch in laparoscopy compared to open surgery. 9 Here-in, we describe our initial experience with using a PEG-coated patch in leu of traditional renorrhaphy during MIPN.…”