Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático

Background: Compared to standard coagulation essays (SCE), such as international normalized ratio (INR), prothrombin activated partial thromboplastin time (aPTT), or platelet count, thromboelastograhy (TEG) offers precise and real-time information about hemostasis. TEG tests both platelet function...

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Autores principales:	Concha P.,Mario, Mertz K.,Verónica, Muñoz Castillo,Gabriel, Delfino Y.,Alejandro, Cortínez F.,Luis, Montaña R.,Rodrigo, Pedemonte T.,Juan Cristóbal, Fuentes H.,Ricardo
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2018
Materias:	Blood Coagulation Disorders Blood Coagulation Tests Liver Cirrhosis Liver Transplantation Thromboelastography
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000300277
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spelling	oai:scielo:S0034-988720180003002772018-06-20Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepáticoConcha P.,MarioMertz K.,VerónicaMuñoz Castillo,GabrielDelfino Y.,AlejandroCortínez F.,LuisMontaña R.,RodrigoPedemonte T.,Juan CristóbalFuentes H.,Ricardo Blood Coagulation Disorders Blood Coagulation Tests Liver Cirrhosis Liver Transplantation Thromboelastography Background: Compared to standard coagulation essays (SCE), such as international normalized ratio (INR), prothrombin activated partial thromboplastin time (aPTT), or platelet count, thromboelastograhy (TEG) offers precise and real-time information about hemostasis. TEG tests both platelet function and coagulation by assaying several parameters of clot formation dynamically in whole blood. Aim: To evaluate hemostasis in cirrhotic patients undergoing liver transplantation and determine the positive and negative predictive values of SCE for alterations of TEG. Material and Methods: Preoperative SCE and TEG were prospectively analyzed in 25 patients. Results were categorized as normal, laboratory alteration or clinical alteration. SCE results were compared with TEG parameters to determine positive (PPV) and negative predictive values (NPV). Results: Hemostasis was abnormal and laboratory abnormalities were observed in all patients. One patient had clinical signs of excessive bleeding. SCE were abnormal in all patients and TEG was normal in nine patients. The most common alteration in TEG was hypocoagulability, in some cases associated with hypercoagulability and hyperfibrinolysis. Two patients had solely hypercoagulability. PPV of INR, aPTT, platelet count and fibrinogenemia were 0, 0, 0.5 and 0.17 respectively. NPV of the same tests were 1, 1, 0.34 and 1 respectively. Conclusions: Hypocoagulability was the most common laboratory alteration, however, clinical signs of coagulopathy were rarely present. SCE had a poor predictive value to diagnose o discard hemostatic abnormalities.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.146 n.3 20182018-03-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000300277es10.4067/s0034-98872018000300277
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Blood Coagulation Disorders Blood Coagulation Tests Liver Cirrhosis Liver Transplantation Thromboelastography
spellingShingle	Blood Coagulation Disorders Blood Coagulation Tests Liver Cirrhosis Liver Transplantation Thromboelastography Concha P.,Mario Mertz K.,Verónica Muñoz Castillo,Gabriel Delfino Y.,Alejandro Cortínez F.,Luis Montaña R.,Rodrigo Pedemonte T.,Juan Cristóbal Fuentes H.,Ricardo Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático
description	Background: Compared to standard coagulation essays (SCE), such as international normalized ratio (INR), prothrombin activated partial thromboplastin time (aPTT), or platelet count, thromboelastograhy (TEG) offers precise and real-time information about hemostasis. TEG tests both platelet function and coagulation by assaying several parameters of clot formation dynamically in whole blood. Aim: To evaluate hemostasis in cirrhotic patients undergoing liver transplantation and determine the positive and negative predictive values of SCE for alterations of TEG. Material and Methods: Preoperative SCE and TEG were prospectively analyzed in 25 patients. Results were categorized as normal, laboratory alteration or clinical alteration. SCE results were compared with TEG parameters to determine positive (PPV) and negative predictive values (NPV). Results: Hemostasis was abnormal and laboratory abnormalities were observed in all patients. One patient had clinical signs of excessive bleeding. SCE were abnormal in all patients and TEG was normal in nine patients. The most common alteration in TEG was hypocoagulability, in some cases associated with hypercoagulability and hyperfibrinolysis. Two patients had solely hypercoagulability. PPV of INR, aPTT, platelet count and fibrinogenemia were 0, 0, 0.5 and 0.17 respectively. NPV of the same tests were 1, 1, 0.34 and 1 respectively. Conclusions: Hypocoagulability was the most common laboratory alteration, however, clinical signs of coagulopathy were rarely present. SCE had a poor predictive value to diagnose o discard hemostatic abnormalities.
author	Concha P.,Mario Mertz K.,Verónica Muñoz Castillo,Gabriel Delfino Y.,Alejandro Cortínez F.,Luis Montaña R.,Rodrigo Pedemonte T.,Juan Cristóbal Fuentes H.,Ricardo
author_facet	Concha P.,Mario Mertz K.,Verónica Muñoz Castillo,Gabriel Delfino Y.,Alejandro Cortínez F.,Luis Montaña R.,Rodrigo Pedemonte T.,Juan Cristóbal Fuentes H.,Ricardo
author_sort	Concha P.,Mario
title	Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático
title_short	Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático
title_full	Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático
title_fullStr	Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático
title_full_unstemmed	Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático
title_sort	comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático
publisher	Sociedad Médica de Santiago
publishDate	2018
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000300277
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Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático

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