Intraoperative Changes in Blood Coagulation and Thrombelastographic Monitoring in Liver Transplantation

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Abstract
Ot lysis were observed during the preanhepatic and an-hepatic stages of surgery. A further general decrease in coagulation factors and platelets, activation of fibrinolysis, and abrupt decrease in levels of factors V and VIII occurred before and with reperfusion of the homograft. Recovery of blood coagulability began 30–60 min after reperfusion of the graft liver, and coagulability had returned toward baseline values 2 hr after reperfusion. A positive correlation was shown between the variables of thrornbelastography and those of the coagulation profile. Thrombelastography was shown to be a reliable and rapid monitoring system. Its use was associated with a 33% reduction of blood and fluid infusion volume, whereas blood coagulability was maintained without an increase in the number of blood product donors. Address correspondence to Dr. Kang, Department of Anesthesiology, Presbyterian University Hospital, De Soto and O'Hara Street, Pittsburgh, PA 15213. The authors thank Mr. Jeffrey M. Yoffe and Mr. Mark Zapp for their technical assistance, Ms. Lisa Cohn for her editorial help, Dr. Ray McKenzie for his support, and the Hellige Company of Germany for the loan of equipment. Accepted for publication April 4, 1985. © 1985 International Anesthesia Research Society...