Transplantation proceedings
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Hepatic resection may be associated with postoperative coagulopathy. However, there is limited information about the predictors affecting coagulopathy after donor hepatectomy. We evaluated the contributors of maximal changes in prothrombin time (PT), activated thromboplastin time (aPTT), and platelet count in the development of postoperative coagulopathy. ⋯ We found that long anesthesia duration, low BMI, and small remnant liver volume were predictors of coagulation derangement. These results provide a better understanding of risk factors affecting changes in coagulation profiles after living donor hepatectomy.
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Randomized Controlled Trial
Thromboelastography-guided transfusion decreases intraoperative blood transfusion during orthotopic liver transplantation: randomized clinical trial.
To test in a prospective randomized study the hypothesis that use of thromboelastography (TEG) decreases blood transfusion during major surgery. ⋯ Thromboelastography-guided transfusion decreases transfusion of fresh- frozen plasma in patients undergoing orthotopic liver transplantation, but does not affect 3-year survival.
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Dynamic preload indices such as stroke volume variation (SVV) and pulse pressure variation (PPV) have yielded false-positive results in patients with right ventricular (RV) dysfunction. We therefore assessed the effect of RV dysfunction on dynamic indices to predict the decrease in cardiac output (CO) during liver transplantation. ⋯ These results suggest that dynamic preload indices may not be sufficiently sensitive to detect a CO decrease in liver transplant recipients with RV dysfunction, emphasizing the importance of evaluating RV function when determining the predictability of dynamic indices.