PhD Scientific Days

Poster Presentation: Clinical Sciences

P24: Hemostasis reserve capacity during bloodless liver transplantation

Előadó neve

Rengeiné Kiss, Tímea

Előadó munkahelye

Semmelweis University Transplantation and Surgery Clinic

Előadó telefonszáma

+36206663044

Előadó e-mail címe

rengeinetimi@gmail.com

Az előadás címe

Hemostasis reserve capacity during bloodless liver transplantation

Szerző(k) neve és munkahelye

Rengeiné Kiss Tímea, . Máthé Zoltán, . Dinya Elek, . Mészáros Judit, . Fazakas János
Clinic of Transplantation and Surgery, Semmelweis University
Faculty of Health and Public Services, Semmelweis University
Faculty of Health Sciences, Semmelweis University

Szekció

Poster Presentation: Clinical Sciences

Data of the presenter

Doctoral School: Pathological Sciences
Program: Health Science Research
Supervisor: Judit Mészáros, János Fazakas
E-mail: rengeinetimi@gmail.com

Text of the abstract

Introduction: The aim of the study was to evaluate the hemostatic changes defined as hemostasis reserve capacity (HRC) in the first perioperative 48 h of bloodless OLTx.
Methods: The HRC in bloodless OLTx pts (n=26) was designed by the implementation of the “Görlinger pyramid methodology” based on lower reserves of RBCs, factor levels and thrombocytes. Laboratory measurements followed by the counting of HRC were done before OLTX (T1), at arrival on ICU (T2) and 12-24-48 h after OLTX (T3-5). The characteristics of the study population were also recorded. The data are given mean±SD and were analyzed with rAnova by SPSS 20.0.
Results: None of the pts needed RBC, FFP or platelets replacement at all, but 7 pts of 26 required FI (2 g) or PCC (1500 IU) substitution in absence of coagulopathy bleeding during surgery. The intraoperative weakening and postoperative improvement of HRC was noticed (T1=T5). A significant decrease of factors were observed due to the intraoperative vascular bleeding, factor consumption and dilution (T1-T2): FI: 0.9±0.5 g/l; FII 28±11%, FV 44±23%; FVII 32±18%; FX: 47±23%; FXIII: 29±23%; ATIII: 36±17%; p<0.001. Platelet count were found modified by 0.2±50% of the preoperative value. Only 7 pts of 26 required FI (2g), FXIII (1250 IU) substitution in lack of bleeding 48h after surgery. As an indicator of the early graft synthesis the factor levels significantly increase in the first 24h (T2-T4) FI with 0.89±0.65 g/l, and next 24h (T3-T5) FII-V-VII with 22±14%, 48±29%, 31±28% p<0.001, except FXIII which remain decreased by 10±19% of the preoperative value.
Conclusions: The individualized, multimodal approach of hemostasis based on repeated evaluation of HRC focuses on the weakest link within the system. In the absence of bleeding some patients needed only factor replacement, so besides bloodless OLTx, the algorithm could be useful in Jehovah witness patient’s hemostasis management.

Azonosító

P24

Kind

Szabad

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

1165

PhD Scientific Days 2017

Budapest, 11-12 April 2017