Related Experiment Video
Updated: Jun 25, 2025
04:23
Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
2.2K
Practice Algorithm of Rotational Thromboelastometry-Guided (ROTEM-Guided) Bleeding Management in Liver
Min-Yi Tsai1, Shun-Ming Chan1, Nan-Kai Hung1
1Department of Anesthesiology, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan.
Asian Journal of Anesthesiology
|May 22, 2024
Summary
Rotational thromboelastometry (ROTEM) effectively manages coagulopathy during liver transplantation (LT), reducing bleeding and transfusion needs. This practice algorithm guides clinicians in optimizing patient outcomes and lowering healthcare costs in LT.
Area of Science:
- Hepatology
- Anesthesiology
- Transfusion Medicine
Background:
- End-stage liver disease causes complex coagulopathy affecting both procoagulant and anticoagulant systems.
- Conventional tests fail to capture these intricate hemostatic disturbances.
- This imbalance can lead to significant bleeding or thrombotic complications during liver transplantation.
Purpose of the Study:
- To present a practice algorithm for managing major bleeding and coagulopathy in liver transplantation (LT).
- To highlight the utility of viscoelastic testing, specifically ROTEM, in guiding transfusion strategies.
- To encourage the adoption of evidence-based guidelines tailored to institutional resources.
Main Methods:
- Utilizing rotational thromboelastometry (ROTEM) for real-time assessment of viscoelastic hemostasis.
- Implementing ROTEM-guided algorithms for bleeding management during LT procedures.
- Reviewing and synthesizing current evidence on coagulopathy management in LT.
Main Results:
- ROTEM effectively detects complex coagulopathies in LT patients.
- ROTEM-guided transfusion algorithms reduce bleeding, transfusion requirements, and complication rates.
- Implementation of these algorithms leads to decreased healthcare costs associated with LT.
Conclusions:
- Viscoelastic testing with ROTEM is crucial for accurate coagulopathy assessment in LT.
- ROTEM-guided management strategies improve patient safety and resource utilization.
- Standardized algorithms enhance the effectiveness of bleeding management protocols in liver transplantation.
