Correlation between rotation thrombelastometry ROTEM analysis and standard haemostatic parameters during liver transplantation.

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 thrombelastometry 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.