Liver transplatation is a definitive therapeutic modality in end stage liver disease and acute hepatic necrosis but massive hemorrhage during operation is still a major problem of succumbing early mortality. Causes of coagulopathy in liver
trasplantation are diverse but coagulopathy is occurred in anhepatic phase especially early stage of revascularization and recoverad graduaily from 30 min. to 2 hour after revascularization.
Early accurate detection and monitoring of blood coagulopathy during operation may be decrease the early surgical mortality.
In this study, we evaluated the effect of TEG monitoring during orthotopic cannine liver transplantations and compared those with usual coagulation studies(PT, aPPT and Fibrinogen level) in predicting coagulopathy.
@ES The results are as follows
@EN 1) During stage II(Anhepatic period), III(Revascularization period) and IV(Closure period), there was no significant change in PT, aPTT and Fibrinogen level than stage I(Dissection period) except 1 or 2 cases.
2) On thromboelastogram, Reaction time(r) & Coagulation time(R+K) were remarkably prolonged in stage II& III and recovered a little in stage IV in all cases.
Maximal Amplitude(MA) and Clot formation rate(alpha) were decreased in stage II & III and recovered in stage IV in all cases.
Whole blood clot lysis index was not significantly changed during transplantation.
3) In orthotopic cannine liver transplantation, TEG is a good device for detection and monitoring of blood coagulpathy and can be substitued for usual coagulation studies, so clinical application of TEG in human OLT is probably feasible and
abvantageous.
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