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Haemostatic disorders during liver transplantation

Published online by Cambridge University Press:  16 August 2006

Y. Ozier ,
A. Steib ,
B. Ickx ,
N. Nathan ,
A. Derlon ,
J. Guay  and
P. De Moerloose
Y. Ozier
Affiliation:
Departments of Anaesthesia, Hôpital Cochin, Paris
A. Steib
Affiliation:
Hôpitaux Universitaires de Strasbourg, France
B. Ickx
Affiliation:
Department of Anaesthesia, CUB Erasme, Bruxelles, Belgium
N. Nathan
Affiliation:
Department of Anaesthesia, Hôpital Dupuytren Limoges
A. Derlon
Affiliation:
Haemostasis Unit, Hôpital Universitaire, Caen, France
J. Guay
Affiliation:
Department of Anaesthesia, Hôpital Maisonneuve-Rosemont, Montreal, Canada
P. De Moerloose
Affiliation:
Haemostasis Unit, University Hospital Geneva, Switzerland
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Abstract

Profound and complex coagulation disorders are encountered during liver transplantation. They include preoperative coagulation disorders related to the liver disease and haemostatic changes related to the procedure itself. They commonly lead to increased intraoperative bleeding, especially due to increased fibrinolysis, the contribution of which can be demonstrated by the relative efficacy of antifibri-nolytics. Given the multifactorial nature of bleeding in liver transplantation, preoperative coagulation tests cannot predict blood loss even if some statistical relationship is occasionally found.Preoperative correction of coagulation defects has not been shown to be effective in reducing intraoperative bleeding. Throughout the procedure, a rapid and sensitive method for monitoring coagulation is necessary in order to guide the rational use of blood components and pharmacological agents. The usefulness of such a method to assist management of blood loss or blood component requirements is poorly documented and controversial.

Keywords

liver transplantationhaemostasisblood coagulationfibrinolysisantifibrinolytic agentsblood coagulation testsblood transfusion
Type
Review
Information
European Journal of Anaesthesiology , Volume 18 , Issue 4 , April 2001 , pp. 208 - 218
Copyright
2001 European Society of Anaesthesiology

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