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Title: Patterns of coagulopathy during liver transplantation: experience with the first 75 cases using thrombelastography.
Austin Authors: McNicol, P L;Liu, G;Harley, I D;McCall, Peter R ;Przybylowski, G M;Bowkett, J;Angus, Peter W ;Hardy, Kenneth John;Jones, Robert M 
Affiliation: Anaesthesia
Issue Date: 1-Dec-1994
Publication information: Anaesthesia and Intensive Care; 22(6): 659-65
Abstract: Using both conventional laboratory clotting profile and thrombelastography, coagulation status was monitored intraoperatively during liver transplantation in the first 75 cases performed at the Austin Hospital between June 1988 and October 1992. Superimposed on a baseline coagulopathy due to liver disease is a specific pattern of coagulation disturbance which occurs during a liver transplant. Fibrinolysis occurs in the anhepatic stage, worsens with early reperfusion and then spontaneously resolves. In addition reperfusion is associated with a transient clotting defect. If blood loss is excessive, coagulopathy due to massive transfusion may compound the situation. Thrombelastography is a measurement technique allowing rapid on-site assessment of functional clotting status. It is particularly useful in liver transplant surgery. In combination with clinical bleeding assessment it facilitates selective use of component therapy (fresh frozen plasma, platelets and cryoprecipitate) and specific drug treatment only when it is appropriate. It also acts as a liver function test, being especially useful in assessing the graft after reperfusion.
Journal: Anaesthesia and Intensive Care
Type: Journal Article
Subjects: Blood Coagulation.physiology
Blood Coagulation Disorders.drug therapy.etiology.physiopathology.prevention & control
Blood Component Transfusion
Blood Loss, Surgical.prevention & control
Blood Transfusion.adverse effects
Fibrin Fibrinogen Degradation Products.analysis
Liver Transplantation.adverse effects.physiology
Monitoring, Intraoperative
Partial Thromboplastin Time
Platelet Count
Reperfusion.adverse effects
Serum Globulins.analysis
Appears in Collections:Journal articles

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