18 June 2015 : Original article
FIBTEM of Thromboelastometry does not Accurately Represent Fibrinogen Concentration in Patients with Severe Hypofibrinogenemia During Liver Transplantation
Hyungseok SeoABEF, Jae-Hyung ChoiBCF, Yeon-Jin MoonBC, Sung-Moon JeongACDEFDOI: 10.12659/AOT.893741
Ann Transplant 2015; 20:342-350
Abstract
BACKGROUND: Among rotation thromboelastometry (ROTEM®) parameters, the maximum clot firmness (MCF) of EXTEM (MCFEX), INTEM (MCFIN) and FIBTEM (MCFFIB) are influenced by both the platelet count and fibrinogen concentration. We evaluated the relative contribution of laboratory variables to MCF amplitude and determined whether the severity of hypofibrinogenemia could affect the relationship between these variables during liver transplantation (LT).
MATERIAL AND METHODS: Retrospective ROTEM® assays with simultaneous laboratory tests in 282 patients receiving LT were analyzed. Relative contribution of platelet and fibrinogen to MCF was assessed and a subgroup analysis based on fibrinogen concentration was performed.
RESULTS: Platelet count accounted for 60% of the variability in both MCFEX and MCFIN, whereas fibrinogen concentration explained 12% and 9%, respectively. In subgroup analysis, platelets accounted for 56–57% of MCFEX and MCFIN variability with fibrinogen <100 mg/dL, and 59% of the variability with fibrinogen ≥100 mg/dL. Fibrinogen was the primary determinant of MCFFIB, accounting for 73% of the variability. However, in severe hypofibrinogenemia (fibrinogen<100 mg/dL), fibrinogen explained only 22% of MCFFIB variability.
CONCLUSIONS: Regardless of the fibrinogen concentration, the platelet count is a constant primary determinant of the MCFEX and MCFIN during LT. However, MCFFIB may predict the fibrinogen concentration less reliably in cases of severe hypofibrinogenemia.
Keywords: Blood Coagulation Tests, Blood Platelets, Fibrinogen, Liver Transplantation, Thrombelastography
562 19
In Press
06 Jun 2023 : Original article
A 15-Year Retrospective Study of Supportive Extracorporeal Therapies Including Plasma Exchange and Continuo...Ann Transplant In Press; DOI: 10.12659/AOT.939745
02 Jun 2023 : Original article
Survival analysis of transplant-associated thrombotic microangiopathy under different diagnostic criteria a...Ann Transplant In Press; DOI: 10.12659/AOT.939890
10 May 2023 : Original article
Incidence of Thromboembolic Complications Following Kidney Transplantation with Short and Extended Aspirin ...Ann Transplant In Press; DOI: 10.12659/AOT.939143
Most Viewed Current Articles
24 Aug 2021 : Review article
Normothermic Machine Perfusion (NMP) of the Liver – Current Status and Future PerspectivesDOI :10.12659/AOT.931664
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review article
Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive ModelsDOI :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
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