USE OF HEPARINASE MODIFIED THROMBELASTOGRAPHY IN LIVER-TRANSPLANTATION

Severe coagulopathies can occur during liver transplantation, particul arly after reperfusion of the grafted liver. Heparin release has been proposed as one of the factors contributing to this coagulopathy, We h ave analysed the thrombelastograph (TEG) traces of 55 patients after r eperfusion using native and heparinase-treated samples. In almost all cases an abnormal native TEG was improved in vitro by heparinase, demo nstrating the presence of heparin or a heparin-like substance. The hep arinase-modified TEG allowed assessment of the underlying coagulation status, providing a rational guide to blood component replacement or t reatment of fibrinolysis.