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Updated: Dec 10, 2025
Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
The use of thromboelastography to assess post-operative changes in coagulation and predict graft function in renal
Carson B Walker1, Hunter B Moore1, Trevor L Nydam1
1Department of Surgery, Division of Transplant Surgery, University of Colorado, USA.
Background:
End stage renal disease (ESRD) is associated with elevated fibrinogen levels and fibrinolysis inhibition. However, there is a paucity of data on how renal transplantation impacts coagulation. we hypothesize that renal transplantation recipients with good functioning grafts will have improved fibrinolytic activity following surgery.
Methods:
Kidney recipients were analyzed pre-operatively and on post-operative day 1(POD1) using three different TEG assays with and without two concentration of tissue-plasminogen activator (t-PA). TEG indices and percent reduction in creatinine from pre-op to POD1 were measured, with >50% defining "good" graft function. Follow up was done at 6, 12, and 24 months.
Results:
Percent lysis(LY30) on POD1 the t-PA TEG was significantly correlated to change creatinine from pre-op to POD-1(p = 0.006). A LY30 ≥ 23% was associated with good early graft function, and lower creatinine at 24-months(p = 0.028) compared to recipients with low POD1 LY30.
Conclusions:
Post-operative tPA-TEG LY30 is associated with favorable early and late outcomes in kidney transplant.
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