Thromboelastography-Guided Transfusion Decreases Intraoperative Blood Transfusion During Orthotopic Liver Transplantation: Randomized Clinical Trial

Abstract Objective To test in a prospective randomized study the hypothesis that use of thromboelastography (TEG) decreases blood transfusion during major surgery. Material and Methods Twenty-eight patients undergoing orthotopic liver transplantation were recruited over 2 years. Patients were random...

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Bibliographic Details
Published in:Transplantation proceedings 2010-09, Vol.42 (7), p.2590-2593
Main Authors: Wang, S.-C, Shieh, J.-F, Chang, K.-Y, Chu, Y.-C, Liu, C.-S, Loong, C.-C, Chan, K.-H, Mandell, S, Tsou, M.-Y
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Blood Coagulation
Blood Loss, Surgical
Blood Transfusion - methods
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Hematocrit
Humans
Intraoperative Period
Liver Transplantation - methods
Liver Transplantation - physiology
Liver, biliary tract, pancreas, portal circulation, spleen
Male
Medical sciences
Middle Aged
Monitoring, Intraoperative - methods
Monitoring, Physiologic - methods
Partial Thromboplastin Time
Prospective Studies
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Thrombelastography - methods
Tissue, organ and graft immunology
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Summary:Abstract Objective To test in a prospective randomized study the hypothesis that use of thromboelastography (TEG) decreases blood transfusion during major surgery. Material and Methods Twenty-eight patients undergoing orthotopic liver transplantation were recruited over 2 years. Patients were randomized into 2 groups: those monitored during surgery using point-of-care TEG analysis, and those monitored using standard laboratory measures of blood coagulation. Specific trigger points for transfusion were established in each group. Results In patients monitored via TEG, significantly less fresh-frozen plasma was used (mean [SD], 12.8 [7.0] units vs 21.5 [12.7] units). There was a trend toward less blood loss in the TEG-monitored patients; however, the difference was not significant. There were no differences in total fluid administration and 3-year survival. Conclusion Thromboelastography-guided transfusion decreases transfusion of fresh- frozen plasma in patients undergoing orthotopic liver transplantation, but does not affect 3-year survival.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2010.05.144