Logo image
Back
Strategies to avoid empiric blood product administration in liver transplant surgery
Journal article   Open access   Peer reviewed

Strategies to avoid empiric blood product administration in liver transplant surgery

Mian Ahmad, Johann Mathew, Usama Iqbal and Rayhan Tariq
Saudi journal of anaesthesia, v 12(3), pp 450-456
01 Jan 2018
DOI: https://doi.org/10.4103/sja.SJA_712_17
PMID: 30100846
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.4103/sja.sja_712_17View
Published, Version of Record (VoR)CC BY-NC-SA V4.0,  Open
url
https://doi.org/10.4103/sja.SJA_712_17View
Published, Version of Record (VoR) Open

Abstract

Hepatic anesthesia liver transplant coagulation liver transplantation point-of-care tests rebalanced hemostasis Review transfusion
Massive blood loss has been a dreaded complication of liver transplantation, and the accompanying transfusion is associated with adverse outcomes in the form of decreased patient and graft survival. With advances in both surgical techniques and anesthetic management during transplantation, blood and blood products requirements reduced significantly. However, transfusion practices vary among different centers. The altered coagulation parameters in patients with liver cirrhosis results in a state of “rebalanced hemostasis” and patients are just as likely to clot as they are to bleed. Commonly used coagulation tests do not always reflect this new state and can, therefore, be misleading. Transfusion of blood products solely to correct abnormal parameters may worsen the coagulation status, thus adversely affecting patient outcome. Point-of-care tests such as thromboelastometry more reliably predict the risk of bleeding in these patients and in addition may provide quicker turnaround times compared to routine tests. Perioperative management should also include the possibility of thrombosis in these patients, and the use of low-molecular-weight heparin correlates with better patient survival. This review article aims to highlight the concept of rebalanced hemostasis, limitation of routine coagulation tests, and harmful effect of empiric transfusion of blood products.

Metrics

6 Record Views
1 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Web of Science research areas
Anesthesiology
Logo image