Reproducibility of TEG Parameters in Stable Cirrhotics

Thromboelastography (TEG) has become the standard of care in liver-transplant surgery to identify real-time abnormalities in the coagulation cascade. To our knowledge, no studies have been performed to measure the intrasubject reproducibility of TEG parameters in cirrhotic patients.

To perform a validation study to determine the reproducibility of TEG in cirrhosis.

We recruited 30 patients with stable cirrhosis and tested 25 of them. Two blood specimens were drawn 1 hour apart; we measured the TEG parameters R time, K time, angle, maximum amplitude (MA), and functional fibrinogen (FF), along with conventional coagulation parameters. Reproducibility was assessed using the intraclass coefficient test. The TEG parameters were then compared with conventional coagulation test results.

The K time, angle, MA, and FF results showed excellent reproducibility (r > 0.7; P <.001). Platelets and fibrinogen correlated with MA and K time; prothrombin time (PT) and activated partial thromboplastin time (aPTT) were inversely correlated with MA.

All parameters were reproducible when measured 1 hour apart. TEG may be suitable to investigate coagulation characteristics in patients with clinically stable cirrhosis; however, further studies are needed in patients with more advanced cirrhosis, in whomblood product use may be more prevalent.