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.