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Orthotopic Kidney Auto-Transplantation in a Porcine Model Using 24 Hours Organ Preservation And Continuous Telemetry
Published on: August 21, 2020
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Rotational thromboelastometry (ROTEM) 24 hours post liver transplantation predicts early allograft dysfunction
Dana Tomescu1,2, Mihai Popescu1,2, Simona Olimpia Dima3
1Fundeni Clinical Institute, Department of Anaesthesia and Critical Care, Bucharest, Romania.
Romanian Journal of Anaesthesia and Intensive Care
|November 6, 2018
Summary
Early allograft dysfunction (EAD) after liver transplantation (LT) is common. Rotational thromboelastometry (ROTEM) parameters can help diagnose EAD and predict graft failure.
Area of Science:
- Hepatology
- Transplantation Surgery
- Coagulation Science
Background:
- Early allograft dysfunction (EAD) is a significant complication following liver transplantation (LT).
- Identifying reliable early indicators of EAD is crucial for patient outcomes.
Purpose of the Study:
- To investigate the utility of rotational thromboelastometry (ROTEM) parameters in diagnosing EAD post-LT.
- To identify intraoperative risk factors associated with EAD.
Main Methods:
- Prospective study of 164 patients undergoing LT.
- Recorded patient demographics, intraoperative blood loss, transfusions, and lactate levels.
- Assessed standard and derived ROTEM parameters 24 hours post-LT; EAD diagnosed by Nanashima criteria.
Main Results:
- 28.6% of patients developed EAD.
- Intraoperative blood loss and transfusions (RBCs, FFP) were risk factors for EAD.
- Elevated lactate levels and altered ROTEM parameters (clot formation time, maximum clot firmness, thrombin potential index, AUC, clot elasticity) were associated with EAD.
Conclusions:
- ROTEM parameters show promise in detecting early signs of graft dysfunction.
- ROTEM may serve as a valuable diagnostic tool for EAD following liver transplantation.
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