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Measurement of Liver Stiffness Using Atomic Force Microscopy Coupled with Polarization Microscopy

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Viscoelastic testing in liver transplantation.

Tetsuro Sakai¹

¹Department of Anesthesiology and Perioperative Medicine, UPMC (University of Pittsburgh Medical Center), Pittsburgh, Pennsylvania, USA.

|October 22, 2020

Summary

This summary is machine-generated.

Viscoelastic tests (VETs) aid hemostatic control in liver transplantation (LT), reducing blood product transfusions. Further research is needed for VET-specific algorithms in LT patients with rebalanced hemostasis.

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Area of Science:

Hepatology
Transplantation Medicine
Coagulation Science

Background:

Viscoelastic tests (VETs) have been utilized for hemostatic control in liver transplantation (LT) since the 1960s.
Despite limited large randomized clinical trials, many institutions incorporate VETs into clinical practice for LT patients.

Purpose of the Study:

To evaluate the impact of VET-guided hemostatic treatment algorithms in liver transplantation.
To assess the role of VETs in diagnosing and predicting hypercoagulability-related complications in LT recipients.

Main Methods:

Analysis of small-size randomized clinical trials involving LT patients undergoing VET-guided hemostasis.
Comparison of VET-guided algorithms with standard laboratory-based hemostatic management.

Main Results:

VET-guided algorithms demonstrated decreased transfusion requirements, particularly for fresh-frozen plasma, compared to standard management.
VETs provided insights into diagnosing and predicting hypercoagulability-related morbidity and mortality in LT patients.

Conclusions:

VETs are valuable tools for hemostatic management in liver transplantation, potentially reducing blood product usage.
There is an ongoing need for device-specific VET algorithms in LT, considering the altered coagulation in end-stage liver disease.