• S-C Wang, J-F Shieh, K-Y Chang, Y-C Chu, C-S Liu, C-C Loong, K-H Chan, S Mandell, and M-Y Tsou.
• Department of Anesthesiology, Taipei Veterans General Hospital, Taiwan.
• Transplant. Proc. 2010 Sep 1;42(7):2590-3.

ObjectiveTo test in a prospective randomized study the hypothesis that use of thromboelastography (TEG) decreases blood transfusion during major surgery.Material And MethodsTwenty-eight patients undergoing orthotopic liver transplantation were recruited over 2 years. Patients were randomized into 2 groups: those monitored during surgery using point-of-care TEG analysis, and those monitored using standard laboratory measures of blood coagulation. Specific trigger points for transfusion were established in each group.ResultsIn patients monitored via TEG, significantly less fresh-frozen plasma was used (mean [SD], 12.8 [7.0] units vs 21.5 [12.7] units). There was a trend toward less blood loss in the TEG-monitored patients; however, the difference was not significant. There were no differences in total fluid administration and 3-year survival.ConclusionThromboelastography-guided transfusion decreases transfusion of fresh- frozen plasma in patients undergoing orthotopic liver transplantation, but does not affect 3-year survival.2010 Elsevier Inc. All rights reserved.

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