Do we need use fresh frozen plasma in patients after liver transplantation?

2017

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DOI 10.26226/morressier.58f5b030d462b80296c9e641
Data confidence 70 medium
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Abstract

Optimal coagulation management remains one of the greatest challenges in orthotopic liver transplantation (OLT). Use coagulation tests and thrombelastography (TEG) may beneficial in determining the optimal coagulation management (1). Aim of study: To estimate need of fresh frozen plasma (FFP) transfusion in patients after liver transplantation.Materials and Methods: after local Ethic Committee approval and informed consent we studied 34 patients with liver cirrhosis, aged 44.0u00b115.4 (24-60) yo, weight 54.8u00b17.3 (48-58) kg. We studied activated partial prothrombine time (APPT), international normalized ratio (INR), fibrinogen A (FGA), platelets count (PLT), thrombelastography (K; R; u03b1 angle; MA; LY30), plasma volume transfused postoperatively, ICU stay and in-hospital stay duration.Results and Discussion: the coagulation tests showed significant prolongation of APPT, decreased of FGA level, increased of INR through 10 days after liver transplantation; while thromboelastography showed slight hypocoagulation status in patients through 1-4 postoperative days.Mean volume of FFP transfused postoperatively was 248.5u00b1704 ml. FFP transfusion (1200-2500 ml) was performed in 4 patients on day 1 after surgery with severe coagulation impairment.ICU stay duration 16.6u00b18.4 days. In-hospital stay duration 58.3u00b119.6 days.Conclusion(s):Patients after liver transplantation with coagulation tests disorders and normal values of TEG do not require FFP transfusionReferences:1. Coakley M, Reddy K, Mackie I, Mallett S. J Cardiothorac Vasc Anesth. 2006 Aug;20(4):548-53.