Thromboelastography does not reduce transfusion requirements in liver transplantation: A propensity score-matched...

Area of Science:

• Transfusion Medicine
• Hepatobiliary Surgery
• Coagulation Monitoring

Background:

• Liver transplantation (LT) is associated with significant blood loss and high transfusion requirements.
• Optimizing hemostasis monitoring is crucial for managing blood product usage during LT.
• Conventional coagulation tests (CCTs) and thromboelastography (TEG) are methods used to guide transfusion strategies.

Purpose of the Study:

• To compare total blood product requirements in liver transplantation (LT) when assisted by thromboelastography (TEG) versus conventional coagulation tests (CCTs).

Main Methods:

• Retrospective observational study at a tertiary care LT center.
• Adult patients undergoing deceased donor LT were included.
• Hemostasis was monitored using TEG or CCTs with corresponding transfusion algorithms; propensity score matching (PSM) was used to control for confounding variables.

Main Results:

• Preliminary analysis indicated lower total blood products, FFP, and RBC transfusions in the TEG group (p<0.001).
• After PSM, no significant difference in total blood product consumption was observed between TEG and CCT groups.
• In a high MELD score subgroup (≥25), TEG showed a trend towards lower FFP and total blood product use, but numbers were too small for definitive conclusions.

Conclusions:

• TEG-guided transfusion in LT did not reduce intraoperative blood product consumption in this cohort.
• Further studies are required to ascertain potential benefits of TEG in the general LT population or specific high-risk subgroups.