Thromboelastography as a Predictor of Outcomes Following Liver Transplantation

C. L. Trautman, W. C. Palmer, C. B. Taner, J. M. Canabal, T. Getz, A. Goldman, M. G. Heckman, N. N. Diehl, D. D. Lee, F. F. Stancampiano

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Abstract

Background Thromboelastography (TEG) has been used perioperatively during liver transplantation (LT) to provide a real-time global hemostasis assessment for targeted blood product replacement. We aimed to analyze the relationship between post-LT TEG results and outcomes. Methods We retrospectively analyzed patients undergoing LT from November 2008 to December 2014 at Mayo Clinic Florida. All 441 single-organ 1st-time LT patients aged ≥18 years requiring post-LT intensive care unit management were included. TEG parameters including r time, k time, α angle, and maximum amplitude were measured regularly during the first 24 hours after LT. Outcomes included return to the operating room secondary to bleeding, length of hospitalization, survival, and early allograft dysfunction. Results A prolonged and/or lengthening r time, k time, and r+k time were all independently associated with increased length of hospitalization after LT. Increased maximum amplitude on the first post-LT TEG was associated with early allograft dysfunction. No notable associations of TEG parameters with survival or return to operating room were observed. Conclusions The association of absolute and temporal TEG value changes with increased length of hospitalization and early allograft dysfunction suggests that TEG may have a role in identifying patients at high risk for these outcomes.

Original languageEnglish (US)
Pages (from-to)2110-2116
Number of pages7
JournalTransplantation Proceedings
Volume49
Issue number9
DOIs
StatePublished - Nov 1 2017

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ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Trautman, C. L., Palmer, W. C., Taner, C. B., Canabal, J. M., Getz, T., Goldman, A., Heckman, M. G., Diehl, N. N., Lee, D. D., & Stancampiano, F. F. (2017). Thromboelastography as a Predictor of Outcomes Following Liver Transplantation. Transplantation Proceedings, 49(9), 2110-2116. https://doi.org/10.1016/j.transproceed.2017.07.015