Case Control Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Nov 28, 2020; 10(11): 345-355
Published online Nov 28, 2020. doi: 10.5500/wjt.v10.i11.345
Intraoperative thromboelastography as a tool to predict postoperative thrombosis during liver transplantation
Lesley De Pietri, Roberto Montalti, Giuliano Bolondi, Valentina Serra, Fabrizio Di Benedetto
Lesley De Pietri, Department of General Surgery, Division of Anaesthesiology and Intensive Care Unit, Nuovo Ospedale Civile di Sassuolo, Sassuolo 41049, Modena, Italy
Roberto Montalti, Department of Public Health, Hepato-Pancreato-Biliary Surgery Section, Federico II University of Naples, Napoli 80138, Italy
Giuliano Bolondi, Surgery and Trauma Department, Intensive Care Unit, Ospedale Bufalini Cesena, Cesena 47521, Italy
Valentina Serra, Fabrizio Di Benedetto, Surgery Department, Hepato-Pancreato-Biliary Surgery, Surgical Oncology and Liver Transplantation Unit, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio Emilia, Modena 41125, Italy
Author contributions: Bolondi G, Serra V, Di Benedetto F collected the data and drafted the paper; Montalti R analyzed the data and performed statistical analysis; De Pietri L designed the research study, drafted and supervised the paper; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by Institutional Review Board of Azienda Ospedliero Universitaria (No. 139/14 approved on October 29, 2014).
Informed consent statement: Patients were not required to give informed consent for this study as the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement (checklist of items).
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lesley De Pietri, MD, Chief Doctor, Director, Department of General Surgery, Division of Anaesthesiology and Intensive Care Unit, Nuovo Ospedale Civile di Sassuolo, Via Francesco Ruini 2, Sassuolo 41049, Modena, Italy. lesley.depietri@yahoo.it
Received: June 17, 2020
Peer-review started: June 17, 2020
First decision: July 25, 2020
Revised: July 28, 2020
Accepted: September 2, 2020
Article in press: September 2, 2020
Published online: November 28, 2020
Processing time: 158 Days and 22.5 Hours
Core Tip

Core Tip: In this study, factors associated with an increased risk of early hepatic artery (HAT) and portal vein thrombosis (PVT) after adult liver transplantation (LT) were identified. In particular, basal and 120’ postreperfusion G value (increased net clot strength), and LY60 measured at 120’ postreperfusion time, were predictors of early HAT and PVT. Longer cold ischemic time was also significantly correlated with these complications. Intraoperative blood products transfusion was not associated with an increased risk of thrombosis. Increased daily surveillance by Doppler ultrasound should be considered for the possible prevention or early detection of HAT after LT for patients at increased risk of early HAT and PVT.