Point of Care Perioperative Coagulation Management in Liver Transplantation and Complete Portal Vein Thrombosis

Table 1

Preoperative ROTEM parameters before and after haemostatic therapy and perioperative values at graft reperfusion and after two rounds of haemostatic therapy.

ROTEM parameters assessed	Range of normal values	Preoperative values		Peri-operative values at graft reperfusion
		Before therapy	After therapy*	Before reperfusion	After the 1st 4 g dose of fibrinogen concentrate	After the 2nd 4 g dose of fibrinogen concentrate (20 min from reperfusion)
EXTEM clotting time, CT (s)	42–74	28	54	42	43	43
EXTEM maximum clot firmness, mCF (mm)	49–71	35	65	36	50	61
EXTEM maximum lysis 30 min post CT, ML30 (%)	0–18	5	0	0	1	0
EXTEM α-angle (°)	63–81	28	70	40	66	72
FIBTEM maximum clot firmness, MCF (mm)	9–25	6	16	6	9	15

∗Fibrinogen concentrate 8 g, prothrombin complex concentrate 2000 IU, tranexamic acid 1 g, and platelets 2 IU. EXTEM: extrinsic thromboelastometry assay incorporating recombinant tissue factor as activation enhancer; FIBTEM: fibrinogen thromboelastometry assay based on the EXTEM assay and incorporating cytochalasin D as platelet inhibitor; EXTEM α-angle (°): angle between the baseline and target to the clotting curve through the 2 mm point, it represents kinetic of platelet and fibrin polymerization.