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Intraoperative coagulation changes in children undergoing liver transplantation
Y Kang1, L M Borland, J Picone
1Department of Anesthesiology, University of Pittsburgh School of Medicine, Pennsylvania.
Anesthesiology
|July 1, 1989
Summary
Pediatric liver transplants show coagulation changes similar to adults, with improvements during surgery but worsening upon reperfusion. These shifts in blood clotting are generally less severe in children.
Area of Science:
- Pediatric Surgery
- Hematology
- Transplantation Medicine
Background:
- Liver transplantation necessitates careful monitoring of blood coagulation.
- Understanding intraoperative coagulation dynamics is crucial for patient outcomes.
Purpose of the Study:
- To analyze intraoperative coagulation changes in pediatric liver transplant recipients.
- To compare pediatric coagulation profiles with adult data.
Main Methods:
- Utilized a simplified coagulation profile (prothrombin time, activated partial thromboplastin time, platelet count).
- Employed thrombelastography for detailed coagulation analysis.
- Monitored eight children undergoing liver transplantation.
Main Results:
- Coagulation parameters improved during preanhepatic and anhepatic stages.
- Significant worsening of coagulation observed upon liver graft reperfusion.
- Fibrinolysis occurred in some patients, with one treated with Epsilon-aminocaproic acid.
Conclusions:
- Pediatric liver transplantation involves distinct intraoperative coagulation alterations.
- Coagulation changes in children resemble adult patterns but are typically less severe.
- Disease type (cholestatic vs. hepatocellular) may influence coagulation response in pediatric patients.