title: Should abnormal coagulation data found in thromboelastography be corrected during liver transplantation? Experience of two cases.
abstract: Coagulopathy is common in patients with end-stage liver disease requiring liver transplantation (LT). Thromboelastography (TEG) test results are used for analyzing coagulation data and making a decision about the transfusion requirements. However, whether it is necessary to correct the abnormal coagulation profile during LT is a matter of considerable debate. Herein, we report our experience with two patients who had LT without blood product transfusion despite TEG results showing abnormal coagulation data. The TEG was performed four times during LT. Although blood product transfusion was necessary according to the TEG guidelines, it was avoided. At the end of operation, the hemoglobin level was 8.5 g/dL and 9.5 g/dL for Patient 1 and Patient 2, respectively. The patients tolerated LT well and their subsequent recovery was uneventful. We suggest that TEG should be used cautiously to make a decision about blood transfusion, as it can be totally avoided in selected cases involving living donor LT.
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chih-Hsien
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Kwok-Wai
authors.initials: KW
authors.lastname: Cheng
authors.affiliation: Department of Surgery and Liver Transplant Program, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chao-Long
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Shao-Chun
authors.initials: SC
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Tsung-Shiao
authors.initials: TS
authors.lastname: Shih
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Bruno
authors.initials: B
authors.lastname: Jawan
authors.affiliation: Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: maomd@hotmail.com.
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Huang
mesh_terms: D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000628:therapy*; D016913:Blood Component Transfusion; D002648:Child; D006801:Humans; D016031:Liver Transplantation; D008875:Middle Aged; D013916:Thrombelastography
keywords: blood component transfusion; liver transplantation; living donors; thrombelastography