Hemostasis and coagulation monitoring and management during liver transplantation
| Autor: | Idoia Aparicio, Antoni Sabaté, Antonia Dalmau |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Liver Cirrhosis
medicine.medical_specialty medicine.medical_treatment Blood Loss Surgical Hemorrhage Platelet Transfusion Liver transplantation Risk Assessment Fibrinolytic Agents Von Willebrand factor medicine Humans Immunology and Allergy Intensive care medicine Blood Coagulation Blood coagulation test Hemostasis Transplantation biology business.industry Anticoagulants Thrombosis Perioperative medicine.disease Antifibrinolytic Agents Liver Transplantation Coagulation Practice Guidelines as Topic biology.protein Fluid Therapy Blood Coagulation Tests Fresh frozen plasma Drug Monitoring business |
| Zdroj: | Current Opinion in Organ Transplantation. 14:286-290 |
| ISSN: | 1087-2418 |
| DOI: | 10.1097/mot.0b013e32832a6b7c |
| Popis: | Purpose of review The objective of this review is to evaluate the present state of nonpharmacological measures, pharmacological measures applied to reduce bleeding and perioperative blood products management during orthotopic liver transplantation. Recent findings Recent studies improve the knowledge in the hemostatic response in cirrhotic patients such as thrombin generation and platelet adhesion due to elevated levels of von Willebrand factor. Restrictive fluid therapy is an important measure to avoid hemodilution and so bleeding. Prophylaxis with antifibrinolytics is being questioned for the risk of thrombosis. Correction of coagulation defects with fresh frozen plasma has not reduced blood loss, and it has been related to worse outcome. Also, platelets administration has a negative effect in the outcome. Summary In order to maintain hemostatic system in compensated cirrhotic patient, every effort we do to improve it must consider not to imbalance it resulting in thrombi-hemorrhagic events. Pharmacological measures must be based on their clinical evidence. Identification of high risk bleeding patients would help in developing coagulation guidelines. |
| Databáze: | OpenAIRE |
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