Intraoperative thromboelastography as a tool to predict postoperative thrombosis during liver transplantation  

作　　者：Lesley De Pietri Roberto Montalti Giuliano Bolondi Valentina Serra Fabrizio Di Benedetto 

机构地区：[1]Department of General Surgery,Division of Anaesthesiology and Intensive Care Unit,Nuovo Ospedale Civile di Sassuolo,Sassuolo 41049,Modena,Italy [2]Department of Public Health,Hepato-Pancreato-Biliary Surgery Section,Federico II University of Naples,Napoli 80138,Italy [3]Surgery and Trauma Department,Intensive Care Unit,Ospedale Bufalini Cesena,Cesena 47521,Italy [4]Surgery Department,Hepato-Pancreato-Biliary Surgery,Surgical Oncology and Liver Transplantation Unit,Azienda Ospedaliero Universitaria di Modena,University of Modena and Reggio Emilia,Modena 41125,Italy

出　　处：《World Journal of Transplantation》2020年第11期345-355,共11页世界移植杂志

摘　　要：BACKGROUND Thromboembolic complications are relatively common causes of increased morbidity and mortality in the perioperative period in liver transplant patients.Early postoperative portal vein thrombosis(PVT,incidence 2%-2.6%)and early hepatic artery thrombosis(HAT,incidence 3%-5%)have a poor prognosis in transplant patients,having impacts on graft and patient survival.In the present study,we attempted to identify the predictive factors of these complications for early detection and therefore monitor more closely the patients most at risk of thrombotic complications.AIM To investigate whether intraoperative thromboelastography(TEG)is useful in detecting the risk of early postoperative HAT and PVT in patients undergoing liver transplantation(LT).METHODS We retrospectively collected thromboelastographic traces,in addition to known risk factors(cold ischemic time,intraoperative requirement for red blood cells and fresh-frozen plasma transfusion,prolonged operating time),in 27 patients,selected among 530 patients(≥18 years old),who underwent their first LT from January 2002 to January 2015 at the Liver University Transplant Center and developed an early PVT or HAT(case group).Analyses of the TEG traces were performed before anesthesia and 120 min after reperfusion.We retrospectively compared these patients with the same number of nonconsecutive control patients who underwent LT in the same study period without developing these complications(1:1 match)(control group).The chosen matching parameters were:Patient graft and donor characteristics[age,sex,body mass index(BMI)],indication for transplantation,procedure details,United Network for Organ Sharing classification,BMI,warm ischemia time(WIT),cold ischemia time(CIT),the volume of blood products transfused,and conventional laboratory coagulation analysis.Normally distributed continuous data are reported as the mean±SD and compared using one-way Analysis of Variance(ANOVA).Nonnormally distributed continuous data are reported as the median(interquartile range)and c

关 键 词：THROMBOELASTOGRAPHY Hepatic artery thrombosis Portal vein thrombosis Liver transplantation Risk factors CIRRHOSIS 

分 类 号：R73[医药卫生—肿瘤]