Open AccessThromboelastography does not predict outcome in different etiologies of cirrhosis
Author(s) -
Hugenholtz Greg C.G.,
Lisman Ton,
Stravitz Richard Todd
Publication year - 2017
Publication title -
research and practice in thrombosis and haemostasis
Language(s) - English
Resource type - Journals
ISSN - 2475-0379
DOI - 10.1002/rth2.12037
Subject(s) - thromboelastography , medicine , cirrhosis , etiology , hemostasis , thrombosis , gastroenterology , population , transplantation , liver transplantation , platelet , surgery , environmental health
Essentials Global hemostasis tests generally indicate preserved hemostatic function in cirrhotic patients. Here we present thromboelastography test results of 270 patients of mixed etiology. Normal results were seen in the majority of patients, although some were hypo‐ or hypercoagulable. Thromboelastography did not predict future bleeding, thrombosis, or risk of transplant or death.Background New laboratory tests that measure global hemostasis indicate generally preserved hemostatic function in patients with cirrhosis. It is not known whether normal hemostatic function is maintained across various subsets of patients. Objectives In the present study, we investigated clot generation and clot lysis kinetics in a large group of patients with different etiologies of disease. Patients/Methods Blood samples of 270 patients with cirrhosis were studied using thromboelastography ( TEG ), which measures the dynamic and physical properties of clot formation and lysis in whole blood. TEG parameters of different subsets of the patient population were compared. Correlations with routine laboratory tests as well as clinical outcomes were explored. Results Overall, TEG parameters were normal and similar between underlying disease etiologies. A proportion of subjects showed hypocoagulable features, with the exception of patients with cholestatic cirrhosis in whom TEG readings showed hypercoagulable features. In all groups, K‐time, α‐Angle, and MA correlated well with platelet counts and fibrinogen plasma levels. After a mean follow‐up of 2 years and 11 months, 31 patients had experienced a bleeding event, 8 had developed thrombosis, and 173 patients (64%) had undergone liver transplantation and/or had died. TEG baseline parameters were similar between patients subdivided according to outcome. Conclusions TEG parameters reflected generally preserved function of the hemostatic system in patients with cirrhosis, with hypo‐ and hypercoagulable features in subsets of patients with specific underlying disease etiologies. Abnormalities in TEG parameters did however not predict bleeding, thrombosis, or risk of liver transplantation and/or death.