Letter to the Editor
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2023; 29(46): 6092-6094
Published online Dec 14, 2023. doi: 10.3748/wjg.v29.i46.6092
Paying attention to the value of thrombelastography and the impact of postreperfusion syndrome on outcomes of liver transplantation
Yu-Li Wu, Lu Che, Yi-Qi Weng
Yu-Li Wu, Lu Che, Yi-Qi Weng, Department of Anesthesiology, Tianjin First Central Hospital, Tianjin 300192, China
Author contributions: Wu YL and Che L wrote this letter; Weng YQ revised the letter; All authors have read and agreed to the publication of the manuscript.
Supported by Tianjin Anesthesia Research Development Program of Bethune Charitable Foundation, No. TJMZ2022-005; Science Technology Foundation of Tianjin Health Bureau, No. ZC20052.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Qi Weng, Doctor, PhD, Chief Physician, Professor, Department of Anesthesiology, Tianjin First Central Hospital, No. 24 Fukang Road, Nankai District, Tianjin 300192, China. wyq2023@nankai.edu.cn
Received: October 13, 2023
Peer-review started: October 13, 2023
First decision: October 31, 2023
Revised: November 8, 2023
Accepted: November 17, 2023
Article in press: November 17, 2023
Published online: December 14, 2023
Processing time: 61 Days and 3.4 Hours
Abstract

Only limited information is available about the connection between massive blood transfusion and postoperative survival rates in pediatric liver transplantation. The aim of Gordon's study was to examine the potential impact of perioperative transfusion on postoperative complications and death in young children receiving pediatric living-donor liver transplantation (PLDLT). The authors concluded that transfusion of a red blood cell volume higher than 27.5 mL/kg during the perioperative period is associated with a significant increase in short- and long-term postoperative morbidity and mortality after PLDLT. However, viscoelastic coagulation monitoring was not utilized in the study; instead, only conventional coagulation monitoring was conducted. Overall, the choice of blood coagulation monitoring method during blood transfusion can have a significant impact on patient prognosis. Several studies have shown that the viscoelastic coagulation testing such as thrombelastography (TEG) is highly sensitive and accurate for diagnosing coagulation dysfunction. Indeed, a TEG-guided blood transfusion strategy can improve prognosis. Moreover, postreperfusion syndrome is one of the most common complications of liver transplantation and an important factor affecting the prognosis of patients and should also be included in regression analysis.

Keywords: Liver transplantation; Child; Blood transfusion; Thrombelastography; Reperfusion Injury; Prognosis

Core Tip: The influence of blood transfusion strategies based on different coagulation testing methods on the outcomes of pediatric liver transplantation cannot be ignored. Additionally, postreperfusion syndrome during liver transplantation can have an important impact on the prognosis of pediatric patients and should be accounted for when studying risk factors for postoperative mortality.