Thromboelastography-guided transfusion decreases intraoperative blood transfusion during orthotopic liver transplantation: randomized clinical trial.
OBJECTIVE
To test in a prospective randomized study the hypothesis that use of thromboelastography (TEG) decreases blood transfusion during major surgery.


METHODS
Twenty-eight patients undergoing orthotopic liver transplantation were recruited over 2 years. Patients were randomized into 2 groups: those monitored during surgery using point-of-care TEG analysis, and those monitored using standard laboratory measures of blood coagulation. Specific trigger points for transfusion were established in each group.


RESULTS
In patients monitored via TEG, significantly less fresh-frozen plasma was used (mean [SD], 12.8 [7.0] units vs 21.5 [12.7] units). There was a trend toward less blood loss in the TEG-monitored patients; however, the difference was not significant. There were no differences in total fluid administration and 3-year survival.


CONCLUSIONS
Thromboelastography-guided transfusion decreases transfusion of fresh- frozen plasma in patients undergoing orthotopic liver transplantation, but does not affect 3-year survival.
Wang
S-C
SC
Department of Anesthesiology, Taipei Veterans General Hospital, Taiwan.
Shieh
J-F
JF
Chang
K-Y
KY
Chu
Y-C
YC
Liu
C-S
CS
Loong
C-C
CC
Chan
K-H
KH
Mandell
S
S
Tsou
M-Y
MY
D000328:Adult; D001777:Blood Coagulation; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000379:methods; D005260:Female; D006400:Hematocrit; D006801:Humans; D007432:Intraoperative Period; D016031:Liver Transplantation / Q000379:methods* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D008991:Monitoring, Physiologic / Q000379:methods; D010314:Partial Thromboplastin Time; D011446:Prospective Studies; D013916:Thrombelastography / Q000379:methods*