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
. 1985 May;39(5):532-6.
doi: 10.1097/00007890-198505000-00015.

The relation of preoperative coagulation findings to diagnosis, blood usage, and survival in adult liver transplantation

F A Bontempo, J H Lewis, D H Van Thiel, J A Spero, M V Ragni, P Butler, L Israel, T E Starzl

The relation of preoperative coagulation findings to diagnosis, blood usage, and survival in adult liver transplantation

F A Bontempo et al. Transplantation. 1985 May.

Abstract

A group of 70 adults with end-stage liver disease received 87 homologous liver transplants from 7/11/81 and 7/11/83. The recipients fell into the following diagnostic categories: postnecrotic cirrhosis (PNC) in 22, primary biliary cirrhosis (PBC) in 18, cancer or neoplasia (CA) in 11, sclerosing cholangitis (SC) in 8 and miscellaneous (MISC) in 11. Survival for six months or longer was 46%: survival by group was PBC = 67%, CA = 55%, PNC = 45%, SC = 25%, and MISC = 18%. Preoperative coagulation profiles were evaluated on 64 of the 70 first transplant patients by assigning a score derived from one point per abnormality in each of 8 tests. Mean coagulation abnormality scores (CAS) were strikingly elevated in the PNC and MISC groups. Mean intraoperative blood product usage was 43 units of RBCs, 40 units of fresh frozen plasma (FFP), 21 units of platelets, and 9 bags of cryoprecipitate. Direct correlations were found between CAS and RBC usage (+0.454, P = less than .001), CAS, and survival of 6 months or longer (-0.281, P = less than .02), and RBC usage and survival (-0.408, P = less than .001). These findings indicate that the degree of coagulation abnormality and the type of liver disease may be predictive of intraoperative blood usage and survival in liver transplantation in adults.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Intraoperative RBCs used in 70 patients. Diagnosis: (M) miscellaneous; (B) primary biliary cirrhosis; (SC) sclerosing cholangitis; (CA) tumor/cancer; and (PNC) postnecrotic cirrhosis.
Figure 2
Figure 2
First liver transplants. Operative blood product used versus coagulation abnormality score in 64 patients.
See this image and copyright information in PMC

References

    1. Starzl TE, Iwatsuki S, Van Thiel DH, et al. Evolution of liver transplantation. Hepatology. 1982;2:614. - PMC - PubMed
    1. Van Thiel DH, Schade RR, Starzl TE, et al. Liver transplantation in adults. Hepatology. 1982;2:637. - PMC - PubMed
    1. Iwatsuki S, Shaw BW, Starzl TE. Current status of hepatic transplantation. Semin Liver Dis. 1983;3:173. - PMC - PubMed
    1. Ragni MV, Lewis JH, Spero JA, Hasiba U. Bleeding and coagulation abnormalities in alcoholic cirrhotic liver disease. Alcohol: Clin Exp Res. 1982;6:267. - PubMed
    1. Ragni MV, Lewis JH, Spero JA. Ascites-induced LeVeen shunt coagulopathy. Ann Surg. 1983;198:91. - PMC - PubMed