Is "intra-operating room" thromboelastometry useful in liver transplantation? A case-control study in 303 patients

Area of Science:

• Hepatology
• Anesthesiology
• Transplantation Surgery

Background:

• Coagulation monitoring is crucial for minimizing blood loss during liver transplantation (LT).
• Thromboelastometry (TEM) is an established method for assessing coagulation parameters.
• The impact of intraoperative TEM (orTEM) on LT outcomes remains understudied.

Purpose of the Study:

• To investigate the association between orTEM and operative complications in LT recipients.
• To evaluate the effect of orTEM on long-term outcomes, including survival and postoperative complications.
• To determine if orTEM influences blood product utilization during LT.

Main Methods:

• A case-control study involving 303 liver graft recipients.
• Analysis of variables linked to operative complications and long-term LT outcomes.
• Comparison of outcomes between patients monitored with orTEM and those without.

Main Results:

• orTEM use was associated with reduced blood product transfusion in high-risk patients (MELD ≥ 21, retransplantation, high surgical difficulty, significant bleeding).
• Patients monitored with orTEM demonstrated improved survival rates.
• A lower incidence of postoperative complications was observed in the orTEM group.

Conclusions:

• Intraoperative thromboelastometry (orTEM) is a valuable tool in liver transplantation.
• orTEM facilitates reduced blood product usage and fewer postoperative complications.
• The implementation of orTEM can enhance overall outcomes and survival in liver transplant recipients.