Hemodynamics, fluids & transfusion
Intrinsic or Nonintrinsic End-stage Liver Disease and Its Association With Thromboelastography-based Coagulation States in Patients Undergoing Liver Transplantation: A Retrospective Cohort Study
Authors' conclusion
Liver transplantation candidates with intrinsic liver disease tend to exhibit hypocoagulable TEG patterns, while nonintrinsic disease is associated with hypercoagulability.
Study context
- Population
- Adult liver transplant patients, single quaternary care hospital
- Participants
- 1,078 patients
- Exposure
- Intrinsic vs nonintrinsic end-stage liver disease
- Outcome
- TEG patterns (hypocoagulable, mixed) by etiology of end-stage liver disease
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Hypocoagulable and mixed TEG patterns
Intrinsic vs NonintrinsicOdds ratio (95% CI)P value
Hypocoagulable pattern
3.70(1.94–7.07)
P < 0.0001Mixed pattern
4.59(2.07–10.16)
P = 0.0002Observational data: associations, not effects.
Further findings
Increasing MELD score and thromboelastography (TEG) patterns
| OR (95% CI) | P value | ||
|---|---|---|---|
| Increasing MELDHypocoagulable pattern | 1.14 (1.08–1.19) | P < 0.0001 | |
| Increasing MELDMixed pattern | 1.08 (1.03–1.14) | P = 0.0036 | |
| 0.512Odds ratio (log scale) |
Child-Pugh class C and TEG patterns
| OR (95% CI) | P value | ||
|---|---|---|---|
| Child-Pugh CHypocoagulable pattern | 8.55 (3.26–22.42) | P < 0.0001 | |
| Child-Pugh CMixed pattern | 12.48 (3.89–40.03) | P < 0.0001 | |
| 0.050.21520Odds ratio (log scale) |
Major preoperative thrombotic complications and TEG patterns
- Not associated with specific TEG patterns; interaction with liver disease severity observed
Original publication
Intrinsic or Nonintrinsic End-stage Liver Disease and Its Association With Thromboelastography-based Coagulation States in Patients Undergoing Liver Transplantation: A Retrospective Cohort Study. J Cardiothorac Vasc Anesth. Published 23 July 2024. doi:10.
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