Phenotype of fibrinolytic activity and prophylaxis of hyperfibrinolysis in the course of liver transplantation

E.V. Kraisvetnaya, V.V. Osovskikh, A.E. Bautin, D.A. Granov
Keywords: liver transplantation, hypofibrinolysis, thromboelastometry.
Medicinskij al'manah, 2017, issue 3, pages 150-154.

Нyperfibrinolysis is a common cause of non-surgical blood loss during orthotopic liver transplantation (OLT).
The incidence of hypofibrinolysis and its impact on outcomes for OLT recipients are not known. The aim of
the study was to determine the distribution of the phenotypes of fibrinolytic activity (FA) in patients before
OLT with the rotational thromboelastometry (TEM) and to assess the predictive value of the identified phenotypes.
The study was conducted in 146 patients having undergone OLT. At certain time points of the
operation (5 points) TEM was examined, as well as the screening coagulation profile. The current criteria of
normo-, hyper- and hypophybrinolysis described in the literature were used. Patient’s groups with identified
FA phenotypes were compared for a number of laboratory and clinical variables. At the beginning of the
operation the normal fibrinolysis was detected in 64,6%, hypofibrinolysis – in 33,3%, and hyperfibrinolysis in
2,1% of patients. Although patients with normo- and hypofibrinolysis significantly differed in a number of
laboratory parameters, there were no significant differences in the volume of blood loss, the thrombotic
complication rate and the duration of ICU-stay. The detection of the phenotype of hypophybrinolysis in the
recipient before OLT is apparently not a significant risk factor.

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E.V. Kraisvetnaya, V.V. Osovskikh, A.E. Bautin, D.A. Granov Phenotype of fibrinolytic activity and prophylaxis of hyperfibrinolysis in the course of liver transplantation. Medicinskij al'manah 2017; (3): 150–154,