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Protamine sulphate for treatment of severe post‐reperfusion coagulopathy in pediatric liver transplantation
Author(s) -
Gouvêa Glauber,
Toledo Renato,
Diaz Rodrigo,
Auler Lúcio,
Enne Marcelo,
Martinho José Manoel
Publication year - 2009
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2008.01108.x
Subject(s) - medicine , coagulopathy , biliary atresia , hemostasis , liver transplantation , heparin , protamine , protamine sulfate , transplantation , surgery , coagulation , gastroenterology
In this case report, we describe a child with biliary atresia who underwent a living LDLT and developed severe coagulopathy after reperfusion of the graft. The ROTEM ® analysis strongly suggested the presence of either a heparin effect or severe deficiency of coagulation factors. The former diagnosis was supported by a subsequent in‐vitro HEPTEM. A small dose of protamine sulphate was then administered, which promptly restored hemostasis. The remainder of the procedure was uneventful.