Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

28 September 2010

The use of thromboelastometry in the assessment of hemostatsis during orthotopic liver transplantation reduces the demand for blood products

Janusz Trzebicki, Edyta Flakiewicz, Maciej Kosieradzki, Beata Blaszczyk, Marcin Kołacz, Lidia Jureczko, Marek Pacholczyk, Andrzej Chmura, Beata Lagiewska, Wojciech Lisik, Dariusz Wasiak, Dariusz Kosson, Artur Kwiatkowski, Tomasz Lazowski

Ann Transplant 2010; 15(3): 19-24 :: ID: 881172

Abstract

Background: Bleeding due to fibrinolysis is a serious intraoperative complication during orthotopic liver transplantation (OLT). For a number of years aprotinin was used to minimize risk of this complication. This drug was however banned in 2007 and substituted with other antifibrinolytics. The aim of the study was to assess the potential of intraoperative thromboelastometry to evaluate hemostasis and channelize antifibrinolytic therapy.
Material/Methods: Since ban on aprotinin, 39 patients underwent OLT in our center with no monitoring of fibrinolysis (NMF). Severe disturbances of hemostasis assessed clinically only as a need for blood and blood products transfusion and were treated with transfusion of fresh frozen plasma only. In 2008 we started to use thromboelastometry (ROTEM group, n=39), which allowed for targeted treatment of hyperfibrinolysis with tranexamic acid.
Results: The need for blood transfusion in ROTEM group was insignificantly a lower than in NMF group (4.1±4.76 vs 5.53±4.89 units, p=0.2). Patients from ROTEM group required also less plasma transfusions (10.01±7.47 vs 13.15±6.62, p=0.06). Severe fibrinolysis was found in 3 patients from ROTEM group (7.7%) and was treated with tranexamic acid.
Conclusions: Thromboelastometry provides an immediate diagnosis of fibrinolysis, justifies implementation of targeted treatment and confirms effectiveness of the therapy. In a larger study group it can also result in significant minimization of blood products transfusion during OLT.

Keywords: Aprotinin, Blood Transfusion, Fibrinolysis, Liver Transplantation, thromboelastometry

0 Comments

SARS-CoV-2/COVID-19

17 June 2022 : Case report  

Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature Review

Ann Transplant In Press; DOI: 10.12659/AOT.935874  

12 April 2022 : Letter/Correspondence  

Pancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transpla...

Ann Transplant 2022; 27:e935863

12 November 2021 : Original article  

Coronavirus Disease 2019 (COVID-19) in Solid Organ Transplant Recipients: A Case-Control Study

Ann Transplant 2021; 26:e933152

26 October 2021 : Original article  

Safety of Antithymocyte Globulin Use in Kidney Graft Recipients During the COVID-19 Pandemic

Ann Transplant 2021; 26:e933001

In Press

23 Jun 2022 : Original article  

Evaluation of Deceased Donor Kidney Transplantation in the Eurotransplant Senior Program in Comparison to S...

Ann Transplant In Press; DOI: 10.12659/AOT.936514  

21 Jun 2022 : Case report  

Extrapulmonary Manifestations of SARS-CoV-2: A Report of 3 Cases and a Literature Review

Ann Transplant In Press; DOI: 10.12659/AOT.935874  

20 Jun 2022 : Original article  

The Association Between Tacrolimus Levels and Hyperkalemia in Allograft Recipients Who Underwent Heart or L...

Ann Transplant In Press; DOI: 10.12659/AOT.935607  

15 Jun 2022 : Original article  

Donor CYP3A5 Expression Decreases Renal Transplantation Outcomes in White Renal Transplant Recipients

Ann Transplant In Press; DOI: 10.12659/AOT.936276  

Most Viewed Current Articles

26 Jan 2022 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

29 Dec 2021 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

24 Jul 2020 : Review article  

Kidney Transplantation in the Times of COVID-19 – A Literature Review

DOI :10.12659/AOT.925755

Ann Transplant 2020; 25:e925755

15 Mar 2022 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358