INTRODUCTION: During the anhepatic phase of liver transplantation (LT), fibrinolytic activity increases, since the liver clears tissue plasminogen activator (tPA). We hypothesize that patients who fail to reduce fibrinolytic activity following graft reperfusion will have an increased rate of early allograft dysfunction (EAD). METHODS: Assessment of fibrinolysis in liver transplant recipients was quantified with thrombelastography (TEG) LY30. Changes in LY30 were assessed after graft reperfusion. The 30-min post-reperfusion LY30 was subtracted from the anhepatic LY30 quantifying fibrinolytic changes (delta-LY30). RESULTS: Seventy-three primary LT patients were included in the analysis. Receiver operating characteristic curve (ROC) analysis identified an inflection point of delta-LY30-5.3% as a risk factor for EAD. EAD occurred in 44% of these patients compared to 5% in high delta-LY30 (p = 0.002). CONCLUSION: LT recipients that develop hyperfibrinolysis who fail to reduce fibrinolytic activity 30 min after graft reperfusion had an EAD rate 8-fold higher than patients who had a large reduction in LY30 following reperfusion.
INTRODUCTION: During the anhepatic phase of liver transplantation (LT), fibrinolytic activity increases, since the liver clears tissue plasminogen activator (tPA). We hypothesize that patients who fail to reduce fibrinolytic activity following graft reperfusion will have an increased rate of early allograft dysfunction (EAD). METHODS: Assessment of fibrinolysis in liver transplant recipients was quantified with thrombelastography (TEG) LY30. Changes in LY30 were assessed after graft reperfusion. The 30-min post-reperfusion LY30 was subtracted from the anhepatic LY30 quantifying fibrinolytic changes (delta-LY30). RESULTS: Seventy-three primary LT patients were included in the analysis. Receiver operating characteristic curve (ROC) analysis identified an inflection point of delta-LY30-5.3% as a risk factor for EAD. EAD occurred in 44% of these patients compared to 5% in high delta-LY30 (p = 0.002). CONCLUSION: LT recipients that develop hyperfibrinolysis who fail to reduce fibrinolytic activity 30 min after graft reperfusion had an EAD rate 8-fold higher than patients who had a large reduction in LY30 following reperfusion.
Authors: Hunter B Moore; Ernest E Moore; Matthew D Neal; Forest R Sheppard; Lucy Z Kornblith; Dominik F Draxler; Mark Walsh; Robert L Medcalf; Mitch J Cohen; Bryan A Cotton; Scott G Thomas; Christine M Leeper; Barbara A Gaines; Angela Sauaia Journal: Anesth Analg Date: 2019-09 Impact factor: 5.108
Authors: Hunter B Moore; Ernest E Moore; Peter J Lawson; Eduardo Gonzalez; Miguel Fragoso; Alex P Morton; Fabia Gamboni; Michael P Chapman; Angela Sauaia; Anirban Banerjee; Christopher C Silliman Journal: Surgery Date: 2015-06-05 Impact factor: 3.982
Authors: W R Kim; J R Lake; J M Smith; D P Schladt; M A Skeans; S M Noreen; A M Robinson; E Miller; J J Snyder; A K Israni; B L Kasiske Journal: Am J Transplant Date: 2019-02 Impact factor: 8.086
Authors: Antoni R Macko; Hunter B Moore; Andrew P Cap; M Adam Meledeo; Ernest E Moore; Forest R Sheppard Journal: J Trauma Acute Care Surg Date: 2017-04 Impact factor: 3.313
Authors: Hunter B Moore; Yanik J Bababekov; James J Pomposelli; Megan A Adams; Cara Crouch; Dor Yoeli; Rashikh A Choudhury; Tanner Ferrell; James R Burton; Elizabeth A Pomfret; Trevor L Nydam Journal: Am J Surg Date: 2022-02-19 Impact factor: 3.125