Evaluation of "flat-line" thromboelastography after reperfusion during liver transplantation

Transplantation Proceedings
E H KimSuk-Koo Lee

Abstract

"Flat-line" (no clot formation) thromboelastography (TEG) is frequently observed after graft reperfusion during liver transplantation (LT). We aimed to evaluate the incidence and causes of flat-line TEG after graft reperfusion during LT. With institutional review board approval, data of 208 consecutive recipients who underwent LT from May 2010 to May 2012 were retrospectively reviewed. We performed 3 different types of TEG measurements at 5 minutes after graft reperfusion: native TEG (nTEG), tranexamic acid-added TEG (tTEG), and protamine-added TEG (pTEG). The flat-line TEG was defined as having no trace at all at 60 minutes of TEG. We examined the incidence and causes of flat-line nTEG. We also compared recipients with flat-line nTEG (F group) and clot-forming nTEG (C group). One hundred eighty-two recipients were included in the final analysis. The incidence of flat-line nTEG was 27% (49/182 cases). Among 49 recipients in the F group, 28 recipients showed clot formation in both tTEG and pTEG, 19 recipients in only tTEG, and 1 recipient in only pTEG; 1 recipient showed no clot formation in any TEGs. Graft from the deceased donor was more frequently observed in the F group than in the C group (P = .039). The F group showed decr...Continue Reading

References

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May 30, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Seema AgarwalSusan V Mallett
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Jun 16, 2010·Journal of Hepatology·Ton LismanUNKNOWN Coagulation in Liver Disease Study Group
Oct 19, 2011·Archives of Surgery·Jonathan J MorrisonMark J Midwinter
May 23, 2013·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Dominik KrzanickiSusan Mallett

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Citations

Dec 29, 2015·Transplantation Proceedings·A Sabate, A Dalmau
Feb 22, 2017·International Anesthesiology Clinics·Zachary Henry, Patrick G Northup
Jan 10, 2018·Clinical Transplantation·Rachel HogenAaron Strumwasser
May 18, 2019·Korean journal of anesthesiology·Klaus GörlingerTae-Yop Kim
Jan 1, 2016·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Mauro PanigadaLuciano Gattinoni
Jul 2, 2020·Transfusion·Alicia DillardMelissa M Cushing
Nov 4, 2017·Seminars in Cardiothoracic and Vascular Anesthesia·Kevin P Blaine, Tetsuro Sakai
Apr 21, 2021·Seminars in Thrombosis and Hemostasis·Maria J ColominaAntoni Sabate

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