Efficacy of pro‐ and anticoagulant strategies in plasma of patients undergoing hepatobiliary surgery

Abstract

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Perioperative Coagulation Profile in Major Liver Resection for Cancer: A Prospective Observational Study

“…Although the most feared complication after major liver resection is bleeding, there is increasing evidence of the opposite. 44 Liver resection has been associated with normal or even hyper-coagulable state in the early post-operative period. 19 On the other hand, cancer alone, and even more so gastrointestinal cancer, represents an acquired prothrombotic condition, and thus cancer patients are at high risk of venous thromboembolism.…”

Clinically relevant increases in the international normalized ratio and model of end-stage liver disease score by therapeutic doses of direct oral anticoagulants in patients with cirrhosis

“…We studied samples from 20 adult patients undergoing liver transplantation at King’s College Hospital, London, between September 2017 and December 2017, and 20 healthy individuals recruited in the same study. Patient characteristics have been described previously [ 10 ]. Only samples taken after the induction of anesthesia were studied.…”

Congruent identification of imbalanced fibrinolysis by 2 distinct clot lysis time assays

“…Citrated plasma samples were obtained from patients undergoing orthotopic liver transplantation (OLT) ( n = 20), partial hepatectomy ( n = 20), or pylorus-preserving pancreatico-duodenectomy (PPPD) ( n = 20) at King’s College Hospital, London, United Kingdom, between September 2017 and December 2017. Patient details have been previously published [ 28 ]. In short, blood samples were taken into 3.2% sodium citrate tubes and were centrifuged at 18 °C for 10 minutes at 2000 g and subsequently for 10 minutes at 10,000 g within 30 minutes after blood collection.…”

“…Anti-Xa activity was measured on an automated coagulation analyzer (ACL 300 TOP) by using Heparin LRT (Hyphen Biomed). The ETP was measured by using calibrated automated thrombography, with a protocol and reagents from Thrombinoscope BV, Maastricht, the Netherlands, as described before [ 28 ]. Coagulation was activated with recombinant tissue factor (final concentration 5 pM) and phospholipids (final concentration 4 μM).…”