Hemostatic evaluation of patients undergoing liver transplantation

C. A. Owen, S. R. Rettke, E. J. Walter Bowie, T. L. Cole, C. C. Jensen, R. H. Wiesner, R. A. Krom

Research output: Contribution to journalArticle

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Abstract

A detailed coagulation and thromboelastographic study was done on the first 50 liver transplantation procedures performed at the Mayo Clinic between March 1985 and June 1986. Most of the patients suffered from primary sclerosing cholangitis, primary biliary cirrhosis, or chronic active hepatitis. Seven patients required a second liver transplantation, and six patients died, none intraoperatively. Most of the patients had distorted hemostatic mechanisms preoperatively, as would be expected the liver generates most of the clotting factors. The outstanding exception was factor VIII, which was usually in the high-normal range or even more elevated. Substantial deterioration of coagulation factors occurred regularly during reperfusion of the donor liver. In some instances, this trend was corrected within 1 hour, but platelet counts continued to decrease, and some coagulation factors rebounded only partially. Because thromboelastographic tracings are quickly available to the liver transplant team and because they tend to forewarn of impending hemostatic problems, we believe that thromboelastography is a reasonably effective procedure for monitoring coagulation during liver transplantation.

Original languageEnglish (US)
Pages (from-to)761-772
Number of pages12
JournalMayo Clinic Proceedings
Volume62
Issue number9
StatePublished - 1987
Externally publishedYes

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Hemostatics
Liver Transplantation
Blood Coagulation Factors
Liver
Thrombelastography
Sclerosing Cholangitis
Biliary Liver Cirrhosis
Factor VIII
Chronic Hepatitis
Platelet Count
Reperfusion
Reference Values
Tissue Donors
Transplants

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Owen, C. A., Rettke, S. R., Walter Bowie, E. J., Cole, T. L., Jensen, C. C., Wiesner, R. H., & Krom, R. A. (1987). Hemostatic evaluation of patients undergoing liver transplantation. Mayo Clinic Proceedings, 62(9), 761-772.

Hemostatic evaluation of patients undergoing liver transplantation. / Owen, C. A.; Rettke, S. R.; Walter Bowie, E. J.; Cole, T. L.; Jensen, C. C.; Wiesner, R. H.; Krom, R. A.

In: Mayo Clinic Proceedings, Vol. 62, No. 9, 1987, p. 761-772.

Research output: Contribution to journalArticle

Owen, CA, Rettke, SR, Walter Bowie, EJ, Cole, TL, Jensen, CC, Wiesner, RH & Krom, RA 1987, 'Hemostatic evaluation of patients undergoing liver transplantation', Mayo Clinic Proceedings, vol. 62, no. 9, pp. 761-772.
Owen CA, Rettke SR, Walter Bowie EJ, Cole TL, Jensen CC, Wiesner RH et al. Hemostatic evaluation of patients undergoing liver transplantation. Mayo Clinic Proceedings. 1987;62(9):761-772.
Owen, C. A. ; Rettke, S. R. ; Walter Bowie, E. J. ; Cole, T. L. ; Jensen, C. C. ; Wiesner, R. H. ; Krom, R. A. / Hemostatic evaluation of patients undergoing liver transplantation. In: Mayo Clinic Proceedings. 1987 ; Vol. 62, No. 9. pp. 761-772.
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