Thromboelastography as a Predictor of Outcomes Following Liver Transplantation

Area of Science:

• Hepatology
• Transplantation Medicine
• Critical Care Medicine

Background:

• Thromboelastography (TEG) is utilized perioperatively in liver transplantation (LT) for real-time hemostasis assessment.
• It guides targeted blood product replacement during and after LT procedures.

Purpose of the Study:

• To investigate the correlation between post-LT TEG parameters and patient outcomes.
• To determine if TEG can predict complications following liver transplantation.

Main Methods:

• Retrospective analysis of 441 adult, first-time, single-organ LT patients from Mayo Clinic Florida (2008-2014).
• TEG parameters (r time, k time, α angle, maximum amplitude) were measured within 24 hours post-LT.
• Outcomes assessed included reoperation for bleeding, hospitalization duration, survival, and early allograft dysfunction.

Main Results:

• Prolonged or lengthening r time, k time, and r+k time were independently linked to increased hospitalization length.
• Elevated maximum amplitude on initial post-LT TEG correlated with early allograft dysfunction.
• No significant associations were found between TEG parameters and survival or return to the operating room for bleeding.

Conclusions:

• Changes in absolute and temporal TEG values are associated with prolonged hospitalization and early allograft dysfunction post-LT.
• TEG may serve as a valuable tool for identifying liver transplant recipients at higher risk for specific adverse outcomes.