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Hypercoagulability following major partial liver resection - detected by thrombomodulin-modified thrombin generation testing

Potze, W., Alkozai, E. M., Adelmeijer, J., Porte, R. J. & Lisman, T., Jan-2015, In : Alimentary Pharmacology & Therapeutics. 41, 2, p. 189-198 10 p.

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  • Hypercoagulability following major partial liver resection - detected by thrombomodulin-modified

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BackgroundConventional coagulation tests are frequently prolonged after liver surgery, suggesting a post-operative hypocoagulability. However, these tests are unreliable for assessment of the haemostatic status in these patients. In contrast, thrombin generation testing measures the true balance between pro- and anti-coagulant factors.

AimTo study the perioperative coagulation status in patients undergoing hemi-hepatectomy using thrombin generation assays.

MethodsWe examined thrombin generation profiles in serial plasma samples taken from seventeen patients undergoing right hemi-hepatectomy. Results were compared to ten patients undergoing pancreatic resection and twenty-four healthy volunteers. In addition, we measured conventional coagulation tests and plasma levels of several haemostatic proteins.

ResultsFollowing liver resection, the endogenous thrombin potential (ETP) slightly decreased until post-operative day 7. However, in the presence of thrombomodulin, the ETP increased [from 542nM*min (417-694) at baseline to 845nM*min (789-1050) on post-operative day 3] to values higher than that in healthy subjects (558nM*min (390-680); P

ConclusionsThrombin generation in the presence of thrombomodulin revealed hypercoagulability in patients following liver resection. These results support the recently advocated restrictive use of plasma during liver resection and the exploration of more extensive use of post-operative thrombosis prophylaxis.

Original languageEnglish
Pages (from-to)189-198
Number of pages10
JournalAlimentary Pharmacology & Therapeutics
Volume41
Issue number2
Publication statusPublished - Jan-2015

    Keywords

  • CONVENTIONAL COAGULATION TESTS, FRESH-FROZEN PLASMA, HEPATIC RESECTION, VENOUS THROMBOEMBOLISM, RIGHT HEPATECTOMY, PROTHROMBIN TIME, TRANSFUSION, CIRRHOSIS, THROMBOELASTOGRAPHY, COMPLICATIONS

ID: 15912770