Intraoperative coagulation evaluation of ischemia-reperfusion injury in small bowel transplantation: a way to explore

Transplantation Proceedings
A SiniscalchiS Faenza

Abstract

The success of intestinal transplantation is affected by the extreme susceptibility of the small bowel to ischemia-reperfusion (I/R) injury. Platelet aggregation decreases after reperfusion in small intestinal ischemia and liver transplantation. Thromboelastography (TEG) is a coagulation test performed whole on blood. The aims of this study were to assess coagulation derangements during bowel transplantation to define appropriate modalities of intraoperative coagulation monitoring. A secondary endpoint was to determine whether measurements of coagulation derangements were useful to estimate small intestinal I/R injury. We recruited 19 patients who had undergone elective small bowel transplantation for primary short-gut syndrome. We divided our patients into two groups depending on their reperfusion injury as evaluated with a biopsy after reperfusion: group A composed of eight patients who had a reperfusion injury: group B composed of 11 patients who did not experience this problem. We measured five thromboelastogram indicators (r, k, angle, MA, CL30) at defined intervals: dissection phase (T1), vascular anastomoses phase (T2) as well as 30 minutes (T3) and 120 minutes (T4) after reperfusion during the intestinal reconstruction ...Continue Reading

References

Jul 2, 1999·Thrombosis Research·A Aydemir-KoksoyS Yavuzer
Dec 25, 2003·The Proceedings of the Nutrition Society·G L Carlson
Nov 16, 2004·Anesthesiology Clinics of North America·Raymond M Planinsic
Nov 24, 2004·The Journal of Surgical Research·Kazuhisa ArakawaYasuo Morishita

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