Intraoperative coagulation monitoring and small bowel transplantation: a way to explore

Transplantation Proceedings
E PiracciniS Faenza

Abstract

The existence of coagulation disorders during intestinal transplantation is getting more important for a correct anesthetic management. Both a condition of hypocoagulation and hypercoagulation can happen during the intraoperative course. Thromboelastography (TEG), a test on whole blood coagulation, allows measurement of different phases of coagulation function. The aims of our study were to evaluate coagulation derangements during bowel transplantation using TEG. We measured cold ischemia time in 19 patients who underwent general anesthesia for intestinal transplantation. We measured five TEG indicators (R, K, angle, MA, CL50) at defined intervals: dissection phase (T1), vascular anastomosis phase (T2), 30' (T3) and 120' (T4) after reperfusion during the intestinal reconstruction. We found a statistically significant difference between MA measured at T1 versus T3 and T4. There was no significant relation between MA derangements and ischemia time. Patients showed hypocoagulation pattern during all periods. MA indicator variation between the initial value and the value after reperfusion may relate to release of hypocoagulation factors. We observed important coagulation derangements during small bowel transplantation, particularly...Continue Reading

References

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Nov 24, 2004·The Journal of Surgical Research·Kazuhisa ArakawaYasuo Morishita

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Citations

Dec 20, 2015·Transplantation Reviews·Aparna Dalal
Oct 19, 2011·Clinical Transplantation·Antonio SiniscalchiStefano Faenza

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