AUTHOR: Marco Senzolo, Giacomo Germani
KEYWORDS: Liver transplantation, coagulation, liver disease, bleeding
ABSTRACT: The liver plays key roles in blood coagulation being involved in both primary and secondary hemostasis. Historically, liver transplantation was a long and risky procedure, accompanied by a substantial blood loss and massive transfusion requirements, but in recent years the blood products requirement has decreased. Hemostatic alterations, prevalent during the reperfusion phase, are mainly correlated with hyperfibrinolysis and in some cases associated with severe bleeding. Standard laboratory tests to evaluate hemostasis do not correlate with the bleeding risk in chronic liver disease and during liver transplantation.
Prophylactic correction of hemostatic alterations is not recommended and there is a need for an evidence-based practice in blood transfusion policy during liver transplantation. In addition, attention should be paid to possible thromboembolic
complications after liver transplantation.
Download full text |
