SEER sonorheometry enhances fibrinolysis detection during liver transplantation with heparin

Whole blood viscoelastic tests (VETs) are key for detecting fibrinolysis during orthotopic liver transplantation (OLT). The Quantra System introduces a novel parameter, clot stability to lysis (CSL), for quantifying fibrinolysis. The objective was to assess CSL performance relative to established VET measures.

Data were drawn from a multicenter, prospective study of adults undergoing OLT, with Quantra and ROTEM delta testing performed in parallel. This sub-analysis focused on fibrinolysis-positive samples, emphasizing discordant findings between platforms.

Among 125 enrolled patients, 13 intraoperative samples involving the use of heparin showed discordant results. Calibrated automated thrombinography revealed that Quantra reagents produce slower, reduced thrombin generation compared to ROTEM, diminishing thrombin activatable fibrinolysis inhibitor (TAFI) activity. This enhances sensitivity of Quantra to detect fibrinolysis in these samples.

Quantra's CSL parameter demonstrated improved detection of fibrinolysis in heparinized samples and may support individualized fibrinolysis management during OLT. Broader clinical validation is warranted.