Sự thay đổi của một số chỉ số cầm đông máu ở người bệnh ghép gan từ người cho sống tại Bệnh viện Trung ương Quân đội 108

Abstract

Objective: To investigate the alterations and evaluate the correlations of intraoperative hemostatic parameters of patients undergoing living donor liver transplantation. Subject and method: A retrospective study of 121 patients undergoing living donor liver transplantation at the 108 Military Central Hospital from January 2020 to March 2023. The test results of these parameters including platelet count (PLT), prothrombin ratio (PT%), activated partial thromboplastin time (rAPTT), Fibrinogen, and ROTEM parameters were collected at four different time points: Pre-transplant, anhepatic, reperfusion, and post-transplant during the liver transplant process. Result: PT%, rAPTT, and Fibrinogen tests were critically abnormal at the reperfusion phase and gradually improved after the completion of transplantation process. Meanwhile, PLT gradually decreased throughout the operation and reached the lowest count at post-transplantation. CT INTEM was prolonged at the reperfusion phase. CT EXTEM, however, remained normal throughout the liver transplant process. ROTEM parameters A5, A10, MCF of EXTEM, and FIBTEM, were low at the reperfusion phase and fell to the lowest at the post-transplantation. PT% and CT EXTEM results were inversely correlated at a moderate level. The correlation between CT INTEM and rAPTT, Fibrinogen and A10 EXTEM, A10 FIBTEM were high. Platelet count had a very strong correlation with A10, MCF EXTEM. Conclusion: Coagulation-hemostatic tests began to change at the anhepatic phase and escalated to the peak at the reperfusion phase but improved at immediate post-transplantation. There was a moderate to strong correlation between ROTEM parameters and PLT, PT%, rAPTT, Fibrinogen at various phases of liver transplantation.