Postoperative coagulation profiles of patients undergoing adult-to-adult living donor liver transplantation—A single-center experience

Coagulopathy and hemostasis management in patients undergoing liver transplantation

“…[32] However, patients with acutely decompensated (AD) cirrhosis and F I G U R E 1 Dynamic changes in hemostasis across phases of care in patients with liver disease undergoing LT. Changes in primary and secondary hemostasis as well as fibrinolysis are outlined. Initial changes in patients with cirrhosis (yellow) are shown with subsequent dynamic changes associated with the perioperative period (green) and ultimately a return to normalcy in the posttransplant period (orange) [8][9][10][11][12][13][14][15] acute-on-chronic liver failure (ACLF) develop clinically significant changes in the hemostatic system. [33] One in vitro study compared traditional coagulation profiles, thrombin generation, and fibrinolysis across the spectrum from stable cirrhosis to ACLF.…”

“…[ 7 ] Most hepatocyte‐derived coagulation and anticoagulation factors are low in cirrhosis and decrease as liver disease progresses (Figure 1 ). [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ] Elevated vWF and Factor VIII levels and low protein C levels contribute to a hypercoagulable state. [ 16 , 17 ] In addition, low levels of α2‐antiplasmin, Factor XIII, and plasminogen and higher levels of tissue plasminogen activator affect fibrinolysis.…”

“… Dynamic changes in hemostasis across phases of care in patients with liver disease undergoing LT. Changes in primary and secondary hemostasis as well as fibrinolysis are outlined. Initial changes in patients with cirrhosis (yellow) are shown with subsequent dynamic changes associated with the perioperative period (green) and ultimately a return to normalcy in the posttransplant period (orange) [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ] …”