Original scientific paper
https://doi.org/10.26800/LV-144-supl3-4
Viscoelastic hemostatic tests during liver transplantation – have we changed blood transfusion therapy?
Jadranka Pavičić Šarić
; Odjel za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Merkur
Nataša Paklar
; Odjel za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Merkur
Marijana Rehorić Krkušek
; Odjel za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Merkur
Iva Bačak Kocman
; Odjel za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Merkur
Denis Guštin
; Odjel za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Merkur
Nataša Višković Filipčić
; Odjel za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Merkur
Jelena Zenko
; Odjel za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Merkur
Ileana Lulić
; Odjel za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinička bolnica Merkur
Supplements: 00d_SADRZAJ.pdf
Abstract
Introduction: Liver transplantation is a viable treatment for end stage liver desease in which a terminally ill liver is replaced with a healthy donor liver. Standard laboratory tests (prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin), although correlates with the severity of liver disease, showed inferiority to viscolelastic tests (thrombelastogram – TEG, rotational thrombelastometry – ROTEM) in the assessment of coagulation in the end stage liver desease. The aim of this study was to determine if the intraoperative use of viscolastical tests during liver transplantation have influenced amount of administered blood products. Methods: This retrospective, observational study analyzed the following variables for 76 patients in 2010. (without ROTEM) and 82 patients in 2021. (with ROTEM) who underwent liver transplantation at University Hospital
Merkur: intraoperative fluid replacement (crystalloid, colloid); blood products (deplasmatized erythrocytes, fresh frozen plasma, platelets, cryoprecipitate); total intraoperative fluide losses (blood, diuresis, intercellular space); total compensation of fluids and blood products. Results: In 2010. the average total compensation of fluids and blood products was 18,433 ml, while in 2021. it was 9,838 ml (p <0.0001). Volume of crystalloids administered in 2010. was 5674 ml, in 2021. 4734 ml (p = 0.0015); colloids in 2010. 2244 ml, in 2021. 1949 ml (p = 0.07). Deplasmated erythrocytes administered in 2010. were 2927 ml while in 2021. 1266 ml (p <0.0001). Fresh frozen plasma, platelets and cryoprecipitates administered in 2010. were 5428, 426, 266 ml, in 2021. it was 823 (p <0.0001), 137 (p <0.0001), 366 ml (p <0, 03). Conclusion: The use of viscoelastic tests to monitor hemostasis during liver transplantation significantly reduced the administration of all blood products, except cryoprecipitates whose consumption was increased and did not affect the amount of administered colloids. Reducing the amount of blood products is important given the risks related to transfusion of blood products.
Keywords
LIVER TRANSPLANTATION; BLOOD LOSS; BLOOD PRODUCT TRANSFUSION; THROMBOELASTOMETRY
Hrčak ID:
284142
URI
Publication date:
25.9.2022.
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