title: [Coagulation profiles following donor hepatectomy and implications for the risk of epidural hematoma associated with epidural anesthesia].
abstract: BACKGROUND
  Continuous epidural analgesia has become an accepted technique used in laparotomy including liver resections. Although American Society of Regional Anesthesia and Pain Medicine recommends that epidural catheter be removed with prothrombin time-international normalized ratio (PT-INR) less than 1.5, it is possible that liver surgery causes coagulation disturbances. We examined the postoperative changes in coagulation profiles of living liver donors to elucidate whether hepatectomy increases the risk of epidural hematoma related to removal of epidural catheters or not.
  
  
  METHODS
  From January 2007 to October 2009, 42 living liver related transplantations were performed in Hokkaido University Hospital. We reviewed the donor data including PT-INR obtained during perioperative days [preoperative, immediately postoperative, postoperative day 1, 3 and 7] and epidural catheter-related-complications, retrospectively.
  
  
  RESULTS
  While in all donors values of PT-INR obtained during preoperative periods were within normal limits, 14 donors had a PT-INR over 1.5 during postoperative periods. There was no epidural hematoma case in this study.
  
  
  CONCLUSIONS
  Our study suggested that hepatectomy increases the risk of epidural hematoma related to removal of epidural catheters, even in the living liver transplant donors with normal liver function.
authors.affiliation: Department of Anesthesiology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638.
authors.forename: Tetsutaro
authors.initials: T
authors.lastname: Hase
authors.forename: Koichi
authors.initials: K
authors.lastname: Takita
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morimoto
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D001778:Blood Coagulation Disorders / Q000097:blood / Q000209:etiology; D057785:Catheters / Q000009:adverse effects*; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000209:etiology*; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011517:Prothrombin Time; D012189:Retrospective Studies; D012306:Risk; D014019:Tissue Donors; D055815:Young Adult