Liver disease and its effect on haemostasis during liver transplantation

Elizabeth B. Haagsma*, Chris H. Gips, Hans Wesenhagen, Gustaaf W. van Imhoff, Ruud A. F. Krom

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    14 Citations (Scopus)

    Abstract

    In a prospective study involving 25 consecutive adult orthotopic liver transplantation (OLT) patients, of whom 23 had cirrhosis, we have related pretrans‐plantation recipient parameters to blood loss during transplantation. In phase I (explantation of diseased liver) blood loss was 0.1–7.2 1, in phase 3 (following restoration of the portal blood flow after implantation) 0.1–39.7 1, and total blood loss was 1.6–47.2, median 9.21. Five patients (20%) died from causes directly related to defective haemostasis during the operation. Pretransplantation cholinesterase, antithrombin III and albumin correlated most strongly with blood loss in phase 1; a history of ascites, antithrombin III and cholinesterase levels correlated with blood loss in phase 3, and a history of ascites, urinary sodium and antithrombin III with total blood loss. Cholestasis did not influence blood loss. Portal hypertension per se presumably played only a restricted role. A pretransplant 24‐h urinary sodium excretion of 10 mmol or less and a serum sodium of 132 mmol/1 or less were highly predictive of blood loss exceeding 10 1 during OLT. Urinary sodium determination under test conditions and serum sodium measurement should already be part of the assessment of potential OLT candidates by the referring hospital.
    Original languageEnglish
    Pages (from-to)123-128
    Number of pages6
    JournalLiver
    Volume5
    Issue number3
    DOIs
    Publication statusPublished - 1985

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