Changes of coagulation function during in orthotopic liver transplantation in patients with severe hepatitis and liver cancer

Changes of coagulation function during in orthotopic liver transplantation in patients with severe hepatitis and liver cancer

Hei Ziqing, Gan Xiaoliang, Luo Gangjian, et al. Department of Anesthesiology, Third Affiliated Hospital,Zhong Shan University, Guangzhou 510630 CHINA  

Objective To observe the changes of coagulation function during liver transplantation in patients with severe hepatitis and liver cancer. Methods Nineteen patients with end-stage liver disease undergoing orthotopic liver transplantation (OLT) were assigned into severe hepatitis group (group H,n=8), and liver cancer group(group N,n=11). During operation, blood samples were drawn for determination of prothrombin time (PT), thromboplastin time (TT), activated partial thromboplastin time (APTT), fibrinogen concentration (Fib),platelet count (Plt) and activity of fibrinolysin (PL)before induction(T_0),at 1h during operation (T_1),10min after liver removal (T_2),5min after reperfusion(T_3),and 3h after reperfusion(T_4).

At the same times , ACT, clot rate, and platelet function were monitored by Sonoclot analysis. All the coagulant and anti-fibrinolytic drugs were recorded .Results PT,ACT,TT and PL decreased significantly (P0.05) at T_1 or T_2 compared to T_0 in group H, and TT decreased significantly at T_1,T_2 compared to T_0 in group N(P0.05). ACT, TT, APTT, PL increased significantly, the clot rate, Fib, Plt and PF decreased significantly at T_3 in both groups(P0.05,P0.01). APTT increased significantly at T_4 in both groups(P0.05,P0.01).The clot rate, Plt, PF, and Fib in group H were less than those in group N during operation(P0.05). TT and APTT in group H were more than those in group N at T_1,T_2 and T_4. There was a significant difference in the usage of coagulant and anti-fibrinolytic drugs between two groups(P0.05).

Conclusion The changes of coagulation function during liver transplantation between two groups were similar. The patients in group H needed more coagulant and anti-fibrinolytic drugs.

【Key Words】： Severe hepatitis Liver cancer Liver transplantation Coagulation
【CateGory Index】： R614
【DOI】： cnki:ISSN:1004-5805.0.2006-05-000

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