Is “Intra–operating Room” Thromboelastometry Useful in Liver Transplantation? A Case-Control Study in 303 Patients

Álamo, J.M.; León, Antonio Martín; Mellado, Patricia; Bernal, C. Carmona; Marín, Liliana; Franco, Carmen Cepeda; Suárez, G.; Serrano, Juan Monte; Padillo, Javier; Gómez, Manuel

doi:10.1016/j.transproceed.2013.11.008

Cited by 50 publications

(37 citation statements)

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“…While conventional coagulation testing was used to determine the need for transfusion in our study, viscoelastic testing has gained popularity as a method of directing and decreasing transfusion during OLT . However, there is a lack of consensus on what thromboelastography values need to be corrected to what end‐points given the unique coagulation profile of cirrhotic patients .…”

Section: Discussionmentioning

confidence: 99%

Balanced blood product transfusion during liver transplantation

Hogen

Dhanireddy

Clark

et al. 2018

Clinical Transplantation

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Section: Discussionmentioning

confidence: 99%

Balanced blood product transfusion during liver transplantation

Hogen

Dhanireddy

Clark

et al. 2018

Clinical Transplantation

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“…In the TEG assay, the primary parameters measured include the R time, K time, α angle, the maximum amplitude (MA), the coagulation index, and LY30 (see Table for an explanation of TEG parameters). Both TEG and ROTEM have been extensively used to guide blood product replacement in patients undergoing liver transplantation and cardiovascular surgery . Limited data exist on the use of TEG or ROTEM in the management of inpatients with cirrhosis undergoing invasive procedures.…”

Section: Key Pointsmentioning

confidence: 99%

Thromboelastography‐Guided Blood Product Use Before Invasive Procedures in Cirrhosis With Severe Coagulopathy: A Randomized Controlled Trial

Olson

2019

Clinical Liver Disease

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“…In 2011 TEG/ROTEM could not be recommended for LYX due to the lack of evidence of benefits in outcomes (10) . Despite this, the use of TEG/ROTEM has expanded and new clinical studies have emerged (11,12,13,14,15,16,17,18) . The recommendations we made in 2011 need to be update.…”

Section: Background and Importance Of This Revisionmentioning

confidence: 99%

“…A study was excluded because the protocol that TEG/ROTEM protocol was not used to guide fluid replacement but to guide an intermediate pharmacological action: use of antifibrinolytic drugs (27) . Five trials had the selected outcomes and inclusion criteria and the quality was assessed with a critical appraisal approach to identify bias and confounders (16,17,18,28,29) . Appendix 4 (A,B,C,D,E).…”

Section: Appendixmentioning

confidence: 99%

The effectiveness of Thromboelastography (TEG) or thromboelastometry (ROTEM) to guide transfusion treatment versus usual care in liver transplant.

Rando

2018

AAR

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The effectiveness of Thromboelastography (TEG) or thromboelastometry (ROTEM)to guide transfusion treatment versus usual care in liver transplant. A eficácia da tromboelastografia (TEG) ou tromboelastometria (ROTEM) para orientar o tratamento transfusional versus o tratamento usual no transplante de fígado. La eficacia de la tromboelastografía (TEG) o tromboelastometría (ROTEM) para guiar el tratamiento de transfusión versus la atención habitual en el trasplante de hígado. ABSTRACTThe accuracy of the TEG/ROTEM as diagnostic test has been proved (19) and systematic reviews were performed to aggregate the evidence from different clinical scenarios (mainly cardiac surgery).Assess the impact of the intraoperative point of care use of TEG or ROTEM versus conventional coagulation tests (CCT) on the blood components transfusion, bleeding, complications, mortality, hospitalization and costs during adult LTX surgeries. I used PICOS framework to establish the research questions (objectives section) and the inclusion criteria. Type of studies included. The eligibility criteria were randomized controlled trials and non-randomized controlled trials (RCTs and non-RCTs).Primary outcomes: mortality at maximal follow up, allogeneic transfusion requirements: packaged red cells (PRC), platelets, fresh frozen plasma(FFP), cryoprecipitates), complications (medical adverse event that may be related to the coagulation status). Secondary outcomes: blood loss (however measured by authors), total hospital stays, intensive care unit (ICU) stay, costs (of the transplant surgery or of the patient in-hospital treatment). A total of 183 studies were identified and a PRISMAbased diagram was constructed and 8 of them were selected to assess. Six articles were found in full text and were screened for inclusion and exclusion criteria. Five trials had the selected outcomes and inclusion criteria and the quality was assessed with a critical appraisal approach to identify bias and confounders. In conclusion, TEG/ROTEM directed blood products replacement in LTX might be effective in reducing FFP transfusion during the intraoperative. Further studies are required to confirm this finding and to assess the overall requirements of other blood products, bleeding mortality and complications.

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Is “Intra–operating Room” Thromboelastometry Useful in Liver Transplantation? A Case-Control Study in 303 Patients

Cited by 50 publications

References 10 publications

Balanced blood product transfusion during liver transplantation

Balanced blood product transfusion during liver transplantation

Thromboelastography‐Guided Blood Product Use Before Invasive Procedures in Cirrhosis With Severe Coagulopathy: A Randomized Controlled Trial

The effectiveness of Thromboelastography (TEG) or thromboelastometry (ROTEM) to guide transfusion treatment versus usual care in liver transplant.

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