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Background: The determination of the correlations between simultaneously performed rotation thrombelastometry ROTEM® analysis and standard haemostatic analysis during liver transplantations is indispensable for performing an adequate perioperative haemostatic monitoring.
Methods: Perioperative haemostatic monitoring was performed to 30 patients undergoing orthotopic liver transplantation (13 male (42 %) and 17 female (58 %), age: (mean ± SD; 21±17 years). Standard coagulation parameters (PT, APTT, FIB) were assessed chronometrically on STA-Compact Analyzer (Diagnostica Stago – La Roche), rotation thrombealstometry analyses - on ROTEM® analyzer (Petapharm GmbH) and platelets (PLT) – on Cell Dyn 3700 (Abbott Diagnostica), MAPSS technology.
Results: A protocol was successfully developed for the implementation of perioperative haemostatic control during orthotopic liver transplantations, performing parallel thrombelastometric and standard haemostatic analyses. Significant correlation was established between PT(INR) and EXTEM_CFT ( r = 0.834; p<0.001) and between APTT and INTEM_CFT ( r = 0.707; p<0.001) in the preoperative period (R1). The correlation was reduced to insignificant during the intraoperative periods (R2-R5) and two hours postoperatively (R6). Significant correlation was determined between PLT / INTEM and between FIB / MCF_FIBTEM during all perioperative periods (R1 – R6).
Conclusions: The correlations found in the present study suggest to perform the haemoststic liver transplantation monitoring through a parallel systematic analysis of both standard and rotation thrombelastometry parameters and confirm the ROTEM® method as preferable and highly informative.
DOI: Clin. Lab. 2011;57:407-413
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