Rotation thromboelastometry detects thrombocytopenia and hypofibrinogenaemia during orthotopic liver transplantation

Roullet, Stéphanie; Pillot, J.; Freyburger, G.; Biais, M.; Quinart, Alice; Rault, A.; Revel, Philippe; Sztark, F.

doi:10.1093/bja/aeq022

Cited by 141 publications

(100 citation statements)

References 22 publications

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“…This is in agreement with Roullet et al [81] who demonstrated that EXTEM A10 showed a good correlation to platelet count and plasma fibrinogen levels. The predictable threshold for thrombocytopenia (<50,000 mm -3 ) was reported as an EXTEM A10 < 29 mm and had a sensitivity and specificity of 79% and 60%, respectively.…”

Section: Discussionsupporting

confidence: 93%

Preoperative Thromboelastometry as a Predictor of Transfusion Requirements during Adult Living Donor Liver Transplantation

Fayed

Mourad

Yassen

et al. 2015

Transfus Med Hemother

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Background: The ability to predict transfusion requirements may improve perioperative bleeding management as an integral part of a patient blood management program. Therefore, the aim of our study was to evaluate preoperative thromboelastometry as a predictor of transfusion requirements for adult living donor liver transplant recipients. Methods: The correlation between preoperative thromboelastometry variables in 100 adult living donor liver transplant recipients and intraoperative blood transfusion requirements was examined by univariate and multivariate linear regression analysis. Thresholds of thromboelastometric parameters for prediction of packed red blood cells (PRBCs), fresh frozen plasma (FFP), platelets, and cryoprecipitate transfusion requirements were determined with receiver operating characteristics analysis. The attending anesthetists were blinded to the preoperative thromboelastometric analysis. However, a thromboelastometry-guided transfusion algorithm with predefined trigger values was used intraoperatively. The transfusion triggers in this algorithm did not change during the study period. Results: Univariate analysis confirmed significant correlations between PRBCs, FFP, platelets or cryoprecipitate transfusion requirements and most thromboelastometric variables. Backward stepwise logistic regression indicated that EXTEM coagulation time (CT), maximum clot firmness (MCF) and INTEM CT, clot formation time (CFT) and MCF are independent predictors for PRBC transfusion. EXTEM CT, CFT and FIBTEM MCF are independent predictors for FFP transfusion. Only EXTEM and INTEM MCF were independent predictors of platelet transfusion. EXTEM CFT and MCF, INTEM CT, CFT and MCF as well as FIBTEM MCF are independent predictors for cryoprecipitate transfusion. Thromboelastometry-based regression equation accounted for 63% of PRBC, 83% of FFP, 61% of cryoprecipitate, and 44% of platelet transfusion requirements. Conclusion: Preoperative thromboelastometric analysis is helpful to predict transfusion requirements in adult living donor liver transplant recipients. This may allow for better preparation and less cross-matching prior to surgery. The findings of our study need to be re-validated in a second prospective patient population.

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Section: Discussionsupporting

confidence: 93%

Preoperative Thromboelastometry as a Predictor of Transfusion Requirements during Adult Living Donor Liver Transplantation

Fayed

Mourad

Yassen

et al. 2015

Transfus Med Hemother

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“…Roullet et al [44] concluded that ROTEM ® is useful for the global evaluation of coagulation and the EXTEM was the most informative to evaluate the entire coagulation process. Therefore, the empirical use of blood products uncontrolled by ROTEM ® should not be considered in the current real evidence in the literature [45].…”

Section: Discussionmentioning

confidence: 99%

Thromboelastometric Profile in Patients with Prothrombotic Risk Factors Undergoing Liver Transplantation

Nascimento¹,

Escalante²,

Marinho³

et al. 2017

J Transplant Technol Res

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“…Thromboelastometry may provide an immediate assessment of the state of coagulation, help implement targeted treatment, and help minimize blood product transfusion during liver transplant. [28][29][30] In the present program, factors contributing to the significant decrease in cold ischemia time, operative time, and blood product transfusion (Table 3) included the use of thromboelastometry, increased experience, and performance of > 20 transplants per year.…”

Section: Discussionmentioning

confidence: 99%

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2014

Exp Clin Transplant

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Rotation thromboelastometry detects thrombocytopenia and hypofibrinogenaemia during orthotopic liver transplantation

Abstract: ROTEM is useful for the global assessment of coagulation in the operating theatre. EXTEM was the most informative for assessing the whole coagulation process and A10 showed value in guiding Plt and Fg transfusion.

Cited by 141 publications

References 22 publications

Preoperative Thromboelastometry as a Predictor of Transfusion Requirements during Adult Living Donor Liver Transplantation

Preoperative Thromboelastometry as a Predictor of Transfusion Requirements during Adult Living Donor Liver Transplantation

Thromboelastometric Profile in Patients with Prothrombotic Risk Factors Undergoing Liver Transplantation

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