• Liver Transpl. · Feb 2015

    Comparative Study

    Management of bleeding and transfusion during liver transplantation before and after the introduction of a rotational thromboelastometry-based algorithm.

    • Stéphanie Roullet, Geneviève Freyburger, Maximilien Cruc, Alice Quinart, Laurent Stecken, Magali Audy, Laurence Chiche, and François Sztark.
    • Anesthesia and Intensive care Department I, Bordeaux, France; Liver Transplant Unit, Bordeaux, France.
    • Liver Transpl. 2015 Feb 1;21(2):169-79.

    AbstractOrthotopic liver transplantation (OLT) remains a potentially hemorrhagic procedure. Rotational thromboelastometry (ROTEM) is a point-of-care device used to monitor coagulation during OLT. Whether it allows blood loss and transfusions to be reduced during OLT remains controversial. Excellent correlations and predictive values have been found between ROTEM parameters and fibrinogen. We hypothesized that the use of a ROTEM-based transfusion algorithm during OLT would lead to more fibrinogen transfusion and decreased bleeding and blood transfusion. Sixty adult patients were consecutively included in a prospective, without-versus-with study: 30 in the group without ROTEM results and 30 in the group with the ROTEM-based algorithm. A small and nonsignificant increase in median fibrinogen transfusions was found for the with group (6.0 g versus 4.5 g, P = 0.50). It was not associated with a decrease in blood transfusions or in the number of patients exposed to blood products.© 2014 American Association for the Study of Liver Diseases.

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