• A&A practice · Nov 2018

    Case Reports

    In Situ Cold Perfusion of the Liver on Cardiopulmonary Bypass: Coagulopathy and Its Correction: A Case Report.

    • Mohammed Haque, Adriaan Van Rensburg, Stuart McCluskey, Massimiliano Meineri, and Matteo Parotto.
    • From the Department of Anesthesia, University of Toronto and University Health Network, Toronto, Ontario, Canada.
    • A A Pract. 2018 Nov 15; 11 (10): 263-267.

    AbstractWe report a case of profound coagulopathy after the dual insult of cold in-situ perfusion of the liver and cardiopulmonary bypass in a patient undergoing complex hepatobiliary and cardiovascular surgery. Management of this coagulopathy with conventional blood products was hindered by elevated venous pressures, thought to contribute to persistent bleeding and risked liver and right ventricular dysfunction, necessitating a change in strategy. Anesthesiologists should consider fluid-restrictive strategies to correct coagulopathy in combined liver and cardiac surgery.

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