Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 1989 May;9(5):710-4.
doi: 10.1002/hep.1840090509.

Liver transplantation: intraoperative changes in coagulation factors in 100 first transplants

J H Lewis  1 , F A Bontempo, S A Awad, Y G Kang, J E Kiss, M V Ragni, J A Spero, T E Starzl
Affiliations

Liver transplantation: intraoperative changes in coagulation factors in 100 first transplants

J H Lewis et al. Hepatology. 1989 May.

Abstract

Six intraoperative blood samples were obtained at intervals from each of 100 individuals undergoing their first liver transplants. The patients fell into the following diagnostic categories: postnecrotic cirrhosis 28, primary biliary cirrhosis 20, sclerosing cholangitis 19, miscellaneous diseases 14, carcinoma/neoplasia 12 and fulminant hepatitis 7. Coagulation factor values in the initial (baseline) blood samples varied by patient diagnosis. In general, all factor levels were reduced except factor VIII:C, which was increased to almost twice normal. The slight intraoperative changes in factors II, VII, IX, X, XI and XII suggested that a steady-state relationship existed between depletion (consumption/bleeding) and repletion (transfusion, transit from extra- to intravascular space), even in the anhepatic state. In contrast, there were rapid and very significant falls in factor VIII and fibrinogen and a less pronounced decrease in factor V, all reaching their nadirs in early to mid-Stage III. The cause of these coagulation changes appears to be activation of the fibrinolytic system.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Prothrombin time (PT) (sec), activated partial thromboplastin time (APTT) (sec) and euglobulin lysis time (ELT) (min).
Fig. 2
Fig. 2
Factors II, V, VII and X.
Fig. 3
Fig. 3
Factors I (fibrinogen), IX, XI and XII.
Fig. 4
Fig. 4
Factor VIII (note scale change).
See this image and copyright information in PMC

References

    1. Kang YG. Monitoring and treatment of coagulation. In: Winter PM, Kang YG, editors. Hepatic transplantation: anesthetic and perioperative management. New York: Praeger Publishers; 1986. pp. 151–173.
    1. Bontempo FA, Lewis JH, Van Thiel DH, et al. The relation of preoperative coagulation findings to diagnosis, blood usage, and survival in adult liver transplantation. Transplantation. 1985;39:532–536. - PMC - PubMed
    1. Lewis JH. Coagulation defects. JAMA. 1961;178:1014–1020. - PubMed
    1. Lewis JH. Hemostasis and hemorrhage. Sci Clin. 1971;1:l–66.
    1. Lewis JH, Spero JA, Hasiba U. Bleeding disorders. Garden City, New York: Medical Examination Publishing Co., Inc.; 1978. Diagnostic methods: laboratory tests; pp. 22–34.

Substances