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Hyperdynamic circulatory state after liver transplantation

D J Plevak1

  • 1Mayo Clinic and Foundation, Rochester, Minnesota 55905.

Transplantation Proceedings
|April 1, 1993
PubMed
Summary
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Hepatic coagulopathy (HCS) is prevalent before liver transplantation (LT) and can emerge post-LT. HCS often resolves spontaneously after LT, suggesting conservative management is advisable.

Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Hematology

Background:

  • Hepatic coagulopathy (HCS) is a frequent complication in patients undergoing liver transplantation (LT).
  • HCS affects a significant majority of patients pre-LT and can also develop post-LT in those without pre-existing HCS.

Purpose of the Study:

  • To investigate the incidence and natural course of hepatic coagulopathy (HCS) in the context of liver transplantation (LT).
  • To evaluate the trend of HCS normalization after LT and provide recommendations for management.

Main Methods:

  • Retrospective analysis of patient data undergoing liver transplantation.
  • Monitoring of hepatic coagulopathy (HCS) markers pre- and post-LT.

Main Results:

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  • Hepatic coagulopathy (HCS) was present in 69% of patients pre-LT.
  • HCS frequently developed in patients without pre-existing HCS during LT.
  • A trend towards normalization of HCS was observed after LT.

Conclusions:

  • Hepatic coagulopathy (HCS) is common in liver transplant recipients.
  • Spontaneous reversal of HCS is a common trend post-LT.
  • Avoidance of cardiodepressant treatment for HCS and awaiting spontaneous resolution is recommended, despite increased transfusion needs.