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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Tissue Transplantation01:24

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
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The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
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Related Experiment Video

Updated: Dec 20, 2025

Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
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Transfusional optimization in liver transplant using viscoelastic test guided therapy.

N Lekerika Royo1, A Martinez Ruiz1, J Arco Vázquez1

  • 1Servicio de Anestesiología y Cuidados Críticos, Hospital Universitario Cruces, Baracaldo, Vizcaya, España.

Revista Espanola De Anestesiologia Y Reanimacion
|May 23, 2020
PubMed
Summary

Thromboelastometry (ROTEM) monitoring significantly reduced blood product transfusions, including packed red blood cells (PRBCs) and fresh frozen plasma (FFP), during liver transplantation. ROTEM also identified increased fibrinogen needs compared to conventional tests.

Keywords:
Blood coagulationBlood transfusionCoagulación sanguíneaHemostasiaHemostasisLiver transplantationThromboelastometryTransfusión sanguíneaTrasplante hepáticoTromboelastometría

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Area of Science:

  • Anesthesiology
  • Hepatology
  • Transfusion Medicine

Background:

  • Liver transplantation (LT) often requires significant blood product transfusion.
  • Intraoperative coagulation monitoring is crucial for managing bleeding during LT.
  • Conventional laboratory tests (CLT) have limitations in real-time coagulation assessment.

Purpose of the Study:

  • To evaluate the impact of thromboelastometry (ROTEM) on reducing packed red blood cell (PRBC) transfusions in liver transplantation.
  • To compare transfusion requirements (PRBCs, FFP, platelets, fibrinogen) between ROTEM-guided and conventional laboratory test-guided therapy.
  • To assess the effectiveness of ROTEM in optimizing hemostatic management during LT.

Main Methods:

  • A retrospective cohort study involving 92 liver transplant patients.
  • Patients were randomized into two groups: conventional laboratory tests (CLT) and thromboelastometry (ROTEM) guided therapy.
  • Transfusion data for PRBCs, FFP, platelets, fibrinogen, and tranexamic acid were analyzed using appropriate statistical tests.

Main Results:

  • ROTEM group showed a significant reduction in PRBC transfusion rates (67.4%) compared to the CLT group (84.8%).
  • FFP transfusion rates were significantly lower in the ROTEM group (56.5%) versus the CLT group (84.8%).
  • Fibrinogen administration was higher in the ROTEM group (34.8%) than the CLT group (6.5%), indicating better detection of coagulopathy.

Conclusions:

  • Introduction of ROTEM in hemostatic algorithms significantly decreases FFP and PRBC transfusion rates in liver transplantation.
  • ROTEM-based thresholds improve the detection of fibrinogen requirements compared to CLT.
  • ROTEM offers a valuable tool for optimizing coagulation management and reducing transfusion needs in LT.