Review: The Perioperative Use of Thromboelastography for Liver Transplant Patients

R. B. Hawkins, S. L. Raymond, T. Hartjes, P. A. Efron, S. D. Larson, K. A. Andreoni, E. M. Thomas

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Thromboelastography (TEG) is a viscoelastic test that allows rapid evaluation of clot formation and fibrinolysis from a sample of whole blood. TEG is increasingly utilized to guide blood product resuscitation in surgical patients and transfusions for liver transplant patients. Patients with severe liver failure have significant derangement of their clotting function due to impaired production of procoagulant and anticoagulant factors. Traditional coagulation studies are limited by the short time needed for the result and provide little information about the dynamics and strength of clot formation. In addition, traditional coagulation studies do not correlate well with bleeding episodes and may lead to over-transfusion of various blood products. Evidence is less robust regarding the use of TEG for transfusion management decisions in severe liver failure patients awaiting, undergoing, or immediately after liver transplant surgery. However, the available evidence suggests that systematic implementation of TEG rather than traditional coagulation studies results in the administration of fewer blood products without increased mortality or complications. The purpose of this study is to review the literature regarding the use of TEG in liver failure patients prior to liver transplant, intraoperatively, and postoperatively. Additional high-quality randomized controlled studies should be performed to evaluate the use of TEG to guide transfusion decisions, particularly in the postoperative period following liver transplantation.

Original languageEnglish (US)
Pages (from-to)3552-3558
Number of pages7
JournalTransplantation Proceedings
Volume50
Issue number10
DOIs
StatePublished - Dec 2018

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Fingerprint Dive into the research topics of 'Review: The Perioperative Use of Thromboelastography for Liver Transplant Patients'. Together they form a unique fingerprint.

Cite this