• Indian J Anaesth · Apr 2020

    Correlation between thromboelastography and rotational thromboelastometry values in adult liver transplant recipients.

    • Shweta A Singh, Gopi Krishnan, Hashir Ashraf, Rajkumar Subramanian, Vijaykant Pandey, NasaVaibhav KVKCenter for Liver and Biliary Sciences Anaesthesia and Critical Care, Max Super Speciality Hospital, New Delhi, India., Sumit Goyal, and Subhash Gupta.
    • Center for Liver and Biliary Sciences Anaesthesia and Critical Care, Max Super Speciality Hospital, New Delhi, India.
    • Indian J Anaesth. 2020 Apr 1; 64 (4): 286-291.

    Background And AimsViscoelastic haemostatic assays (VHA) namely Thromboelastogram (TEG) and Rotational thromboelastometry (ROTEM) are used for global assessment of coagulopathy and guiding transfusion during living donor liver transplant (LDLT).We conducted a study to compare the interchangeability of the values obtained from these devices in patients with End stage liver disease (ESLD) undergoing LDLT.MethodsIn 76 patients undergoing LDLT, ROTEM and TEG were performed and assessed for interchangeability using Spearman Correlation. The direction and strength of correlation between equivalent parameters was calculated using Inter Class Correlation (ICC) and Bland Altman analysis.ResultsThe correlation ρ between CT (clotting time) of ROTEM and R of TEG was 0.16 (P = 0.19).The ICC was 0.15, with 95% confidence interval (CI) of -0.38-0.48 (P = 0.25).The ρ of CFT (ROTEM) with K (TEG) was 0.425 (P=<0.001). The ICC was0.49 with 95% CI of 0.17-0.69, P = 0.003.Alpha of ROTEM correlated with Angle of TEG with ρ of 0.475 (P=<0.001). The ICC was 0.61, with 95% CI of 0.36-0.76, P=<0.001.Maximum Clot firmness (MCF) correlated with maximum amplitude (MA) with ρ=0.76 (P=<0.001).The ICC was 0.86, with 95% CI of 0.77-0.92, P=<0.001. Lysis index (L30) of ROTEM correlated clot lysis (CL30) of TEG with ρ of 0.16 (P = 0.18).However, the ICC was 0.45, with 95% CI of 0.11-0.66, P = 0.08. The correlation between CT of ROTEM and R of TEG as well as L30 of ROTEM and CL30 of TEG was not significant.The strongest correlation was found between MCF and MA (P < 0.001). However the MCF/MA showed an agreement of only 86% (ICC = 0.86).ConclusionValues from ROTEM and TEG were not found to be interchangeable.Copyright: © 2020 Indian Journal of Anaesthesia.

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