<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Early allograft dysfunction (EAD) represents one of the most common and serious complications after liver transplantation (LT). Methods. One hundred sixty-four patients who underwent LT were prospectively included in the present study. Patient demographics, intraoperative blood loss and transfusion were recorded at the time of LT. Lactate levels were recorded during surgery and daily for the first 3 postoperative days. Standard and derived rotational thromboelastometry (ROTEM) parameters were recorded 24 hours after LT. EAD was diagnosed according to Nanashima criteria and post anaesthesia care unit length of stay was recorded. Results. Forty-seven patients (28.6%) developed EAD. Intraoperative blood loss (p = 0.01), packed red blood cells (p = 0.04) and fresh frozen plasma (p = 0.01) transfusion represented intraoperative risk factors for EAD. Lactate levels were significantly higher in patients with EAD at all time points. Patients with EAD demonstrated an increased clot formation time and decreased maximum clot firmness in both intrinsically (p &lt; 0.01) and extrinsically (p &lt; 0.01) activated assay, a decreased thrombin potential index (p &lt; 0.01), area under the curve (p &lt; 0.01) and clot elasticity (p &lt; 0.01) on ROTEM assay. Conclusion. Our results show that both standard and derived ROTEM parameters may indicate early signs of graft failure and can aid in the diagnosis of EAD.</p></abstract>

Early allograft dysfunction (EAD) represents one of the most common and serious complications after liver transplantation (LT). Methods. One hundred sixty-four patients who underwent LT were prospectively included in the present study. Patient demographics, intraoperative blood loss and transfusion were recorded at the time of LT. Lactate levels were recorded during surgery and daily for the first 3 postoperative days. Standard and derived rotational thromboelastometry (ROTEM) parameters were recorded 24 hours after LT. EAD was diagnosed according to Nanashima criteria and post anaesthesia care unit length of stay was recorded. Results. Forty-seven patients (28.6%) developed EAD. Intraoperative blood loss (p = 0.01), packed red blood cells (p = 0.04) and fresh frozen plasma (p = 0.01) transfusion represented intraoperative risk factors for EAD. Lactate levels were significantly higher in patients with EAD at all time points. Patients with EAD demonstrated an increased clot formation time and decreased maximum clot firmness in both intrinsically (p < 0.01) and extrinsically (p < 0.01) activated assay, a decreased thrombin potential index (p < 0.01), area under the curve (p < 0.01) and clot elasticity (p < 0.01) on ROTEM assay. Conclusion. Our results show that both standard and derived ROTEM parameters may indicate early signs of graft failure and can aid in the diagnosis of EAD.

Rotational thromboelastometry (ROTEM) 24 hours post liver transplantation predicts early allograft dysfunction

Romanian Journal of Anaesthesia and Intensive Care

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Early allograft dysfunction (EAD) represents one of the most common and serious complications after liver transplantation (LT). Methods. One hundred sixty-four...

Rotational thromboelastometry (ROTEM) 24 hours post liver transplantation predicts early allograft dysfunction

Published Online: Dec 05, 2018

Page range: 117 - 122

Received: May 28, 2018

Accepted: Sep 29, 2018

DOI: https://doi.org/10.21454/rjaic.7518.252.tms

Keywords
liver transplantation, coagulation, rotational thromboelastometry, early allograft dysfunction

© 2018 Mihai Popescu, et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Rotational thromboelastometry (ROTEM) 24 hours post liver transplantation predicts early allograft dysfunction

Published Online: Dec 05, 2018

Page range: 117 - 122

Received: May 28, 2018

Accepted: Sep 29, 2018

DOI: https://doi.org/10.21454/rjaic.7518.252.tms

Keywordsliver transplantation, coagulation, rotational thromboelastometry, early allograft dysfunction

© 2018 Mihai Popescu, et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
liver transplantation, coagulation, rotational thromboelastometry, early allograft dysfunction