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Exp Clin Transplant. 2017 Dec;15(6):664-668. doi: 10.6002/ect.2016.0206. Epub 2017 Jun 5.

Hemodynamic Changes Are Predictive of Coagulopathic Hemorrhage After Living Donor Liver Transplant.

Author information

1
From the Liver Transplantation of Nurse Practitioner, Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan.

Abstract

OBJECTIVES:

Our goal was to evaluate the predictors of coagulopathic hemorrhage after living-donor liver transplant.

MATERIALS AND METHODS:

We retrospectively evaluated 161 patients who had undergone living-donor liver transplant from July 2005 to April 2014 at a single medical institution. Of these patients, 32 developed hemorrhage after transplant. Patients were separated into those with coagulopathy-related hemorrhage (n=15) or noncoagulopathy-related hemorrhage (n=17) based on the results of computed tomography images. Predictors of hemorrhage after living-donor liver transplant evaluated in this study included preoperative, perioperative, and posttransplant factors and hemodynamic status.

RESULTS:

Patients who developed coagulopathy-related hemorrhage had significantly lower pretransplant platelet counts (P = .040), a longer cold-ischemia time (P = .045), more blood loss (P = .040), and earlier onset of hemorrhage (P = .048) than patients who had noncoagulopathy-related hemorrhage after transplant. Results of the generalized estimating equation analysis showed that heart rate and central venous pressure differed significantly between the 2 groups of patients. Heart rates increased significantly during hemorrhage (P < .010). Central venous pressure was higher in the coagulopathic group (P = .005) than in the noncoagulopathic group.

CONCLUSIONS:

Lower pretransplant platelet counts, longer cold ischemia time, more blood loss, earlier onset of hemorrhage, and higher central venous pressure level are indicators of coagulopathic hemorrhage after living-donor liver transplant.

PMID:
28585915
DOI:
10.6002/ect.2016.0206
[Indexed for MEDLINE]
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