Comparison of conventional coagulation tests and thromboelastography for preoperatively assessing blood loss and transfusion during orthotopic liver transplantation

Objective: An effective blood loss and transfusion requirements assessment before orthotopic liver transplantation (OLT) may improve intraoperative bleeding management during OLT. Methods: Sixty-five patients were included in this retrospective, observational study. Correlations of conventional coagulation tests (CCTs) and TEG parameters with blood loss and transfusions were determined using Pearson’s correlation analysis. The most strongly correlating CCTs and TEG parameters were selected for logistic regression and receive operating characteristic (ROC) curve analyses. Results: Prothrombin activity (PTA) showed a strong correlation with packed red blood cells (PRBCs) and fresh frozen plasma (FFP) transfusions (r=-0.838, P<0.001; r=-0.810, P<0.001, respectively). A logistic regression indicated that PTA was an independent predictor for PRBCs and FFP transfusions. The cutoff values that best predicted the transfusion threshold for PRBCs and FFP was 83.5%. Conclusion: CCTs and TEG cannot accurately assess blood loss, but PTA showed better correlations with and good performance for the prediction of PRBC and FFP transfusions during OLT.