Ex vivo addition of fibrinogen concentrate improves the fibrin network structure in plasma samples taken during liver transplantation

摘要: BACKGROUND: Optimal hemostatic management during orthotopic liver transplantation (OLT) remains a challenge. The cause of bleeding OLT is multifactorial, and may include imbalance. Fibrinogen concentrates are increasingly being used to control perioperative OLT. However, administration based on arbitrary thresholds fibrinogen levels. Importantly, studies fibrin clot structure lacking. OBJECTIVE: We determined the efficacy concentrate in correcting structure. METHODS: Plasma samples taken at various times from 15 patients healthy controls were spiked with 1 g L(-1) or saline. Turbidity, fiber density permeability clots assessed. RESULTS: Clotting rate turbidity significantly decreased start surgery, even further surgery. Addition increased clotting all time points, but did not normalize it. Fibrin was reduced after reperfusion as compared surgery controls. improved addition reperfusion. severely impaired polymerization accompanied by controls, which completely restored fibrinogen. CONCLUSIONS: Ex vivo substantially improves structural properties clot, which, particularly reperfusion, shows hypocoagulable features. These data support use complications