The effects of in vitro hemodilution with 6% hydroxyethyl starch (HES) (130/0.4) solution on thrombelastograph analysis in patients undergoing liver transplantation.
BACKGROUND
The aim of this study was to determine the effects of in vitro hemodilution with 6% HES (130/0.4) solution on thrombelastograph(®) (TEG) parameters in whole blood samples from patients with end-stage liver disease (ESLD).


METHODS
Enrollment consisted of 95 patients with ESLD undergoing liver transplantation. Blood was diluted by 11%, 22%, and 33% with 6% HES (130/0.4) solution. Normal saline was used as a control diluent.


RESULTS
When blood was diluted by 33% with normal saline, only the reaction time (r) was increased (p < 0.0001) compared to the baseline value. When blood was diluted with 6% HES (130/0.4), 11% dilution decreased maximum amplitude (MA) (p = 0.003) compared to baseline. At 33% dilution, the r (p < 0.0001, vs. baseline) and K (p < 0.0001, vs. baseline; p < 0.0001, vs. normal saline) increased, and the MA, alpha angle, and coagulation index (p < 0.0001, vs. baseline; p < 0.0001, vs. normal saline) decreased.


CONCLUSIONS
Hemodilution with 6% HES (130/0.4) solution results in TEG abnormalities even with 11% hemodilution, in whole blood samples of patients with ESLD undergoing liver transplantation.
Bang
Si Ra
SR
Department of Anesthesiology and Pain Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
Kim
Yoon Hee
YH
Kim
Gaab Soo
GS
D001777:Blood Coagulation / Q000187:drug effects*; D058625:End Stage Liver Disease / Q000601:surgery*; D005260:Female; D006438:Hemodilution; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012965:Sodium Chloride / Q000494:pharmacology; D013916:Thrombelastography; D014914:Whole Blood Coagulation Time
D006895:Hydroxyethyl Starch Derivatives; D012965:Sodium Chloride