REVERSAL OF POSTREPERFUSION COAGULOPATHY BY PROTAMINE SULFATE IN ORTHOTOPIC LIVER-TRANSPLANTATION

We report details of two liver transplant procedures in which post-rep erfusion coagulopathy was reversed by administration of protamine sulp hate. Both procedures were uncomplicated until about 30 min after repe rfusion of the graft, when the cut surfaces began to ooze blood. Failu re of coagulation was confirmed by thrombelastography and in both case s routine coagulation tests revealed a prolonged kaolin cephalin clott ing time (KCT). A heparin-like effect was suspected. Protamine sulphat e 50 mg was given i.v., resulting in cessation of bleeding and normali zation of the thrombelastogram and KCT.