Premium
Rotational thromboelastometry and standard coagulation tests for live liver donors
Author(s) -
Mohammed Maged,
Fayed Nirmeen,
Hassanen Ashraf,
Ahmed Fatma,
Mourad Wessam,
El Sheikh Maha,
Abofetouh Fawzia,
Yassen Khaled,
Khalil Magdy,
Marwan Ibrahim,
Tanaka Koichio
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12067
Subject(s) - thromboelastometry , medicine , prothrombin time , coagulation , fibrinogen , partial thromboplastin time , anesthesia , platelet , coagulation testing , thrombin time
Purpose To study coagulation of live liver donors with standard coagulation tests ( SCT ) and rotational thromboelastometry ( ROTEM ) and investigate their relationship. Methods A descriptive prospective study involving 50 right hepatotomy donors with epidural catheters. ROTEM ( EXTEM , INTEM , and FIBTEM represent extrinsic and intrinsic pathways of coagulation and fibrinogen activity, respectively) was measured perioperatively and on days 1, 3, 5, 10, and 30. SCT s include prothrombin time ( PT ), international normalized ratio ( INR ) of PT , activated partial thromboplastin time (a PPT ), fibrinogen, and platelets. Results PT and INR reflect hypocoagulability reaching maximum on day one (16.9 ± 2.5 s, 1.4 ± 0.2, p < 0.05 compared with baseline). ROTEM was in normal ranges till day 30 with no hypercoagulability. Fibrinogen showed no correlation with maximum clot firmness ( MCF ) of FIBTEM ( r = 0.35, p > 0.05). CFT of EXTEM was not in significant correlation with PT and INR ( r = 0.16, 0.19, p > 0.05), respectively. Significant correlation between platelets and both MCF ( EXTEM ; r = 0.59, p = 0.004) and MCF ( INTEM ; r = 0.48, p = 0.027). Conclusion ROTEM disagreed with SCT s and did not show the temporary hypocoagulability suggested by SCT s. Both ROTEM and SCT s showed no signs of hypercoagulability. Future studies involving ROTEM could help develop new guidelines for coagulation monitoring.