Thromboelastography Parameters Suggestive of Hypercoagulability and its Correlation with Thrombotic Complications in Liver Transplantation- A Retrospective Study
Introduction: Conventional coagulation parameters like, Prothrombin Time (PT), International Normalised Ratio (INR) reflects only the synthesis or status of procoagulant factor levels. Whereas, Thromboelastograph (TEG) reflects ongoing coagulation process and helps in identifying hypocoagulable...
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JCDR Research and Publications Private Limited
2021-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| author | satish logidasan kanimozhi rathinasamy gowrishankar anjeneyan |
| author_facet | satish logidasan kanimozhi rathinasamy gowrishankar anjeneyan |
| author_sort | satish logidasan |
| collection | DOAJ |
| description | Introduction: Conventional coagulation parameters like,
Prothrombin Time (PT), International Normalised Ratio (INR)
reflects only the synthesis or status of procoagulant factor
levels. Whereas, Thromboelastograph (TEG) reflects ongoing
coagulation process and helps in identifying hypocoagulable or
hypercoagulable status. The hypercoagulable TEG parameters
in the perioperative period can guide the physicians to prevent
adverse thrombotic complications, instead of depending on the
Conventional Coagulation Tests (CCTs), which has the potential
to mislead and may delay appropriate clinical interventions.
Aim: To establish, if correlation exists between TEG parameters
suggestive of hypercoagulability and the occurrence of perioperative
thrombotic complications and also to see if CCT correlates with
hypercoagulable TEG parameters in liver transplantation.
Materials and Methods: This was a retrospective analysis
which was done in 32 patients of Diseased Donor Liver
Transplantion (DDLT), from August 2018 to September 2019 at
tertiary care centre in Chennai, Tamil Nadu, India. Data were
analysed for correlation with hypercoagulable TEG parameters
and perioperative thrombotic events. Thromboelastograph
parameters were also compared with CCT like INR, platelet
count. The Mann-Whitney U-test was considered significant if
p-value <0.05, at 95% confidence interval.
Results: Amongst the aetiology of the transplanted patients
(32), the highest number of patients in the present study had
alcoholic liver disease {n=11 (34.37%}. A comparison of paired
G values with International Normalised Ratio (INR) showed that
there was no significant correlation between G value and INR
{r= -0.2, p-value=0.47 (Spearman’s rank correlation)}. The G values
were compared with platelet counts and a moderate correlation was
found (r=0.62, p-value <0.001). The patients with high G traces had
platelet counts of normal reference range. There was no correlation
between the R time and INR (r-value=0.04), (p-value=0.32).
Conclusion: Thromboelastograph parameters suggestive of
hypercoagulability can be useful to predict the occurrence of
thrombotic complications in liver transplant surgery. The present
study found a moderate correlation was seen between the G
value in TEG and platelet counts. No correlation was present
between r value and INR value. There is always a possibility of
aggravating the thrombotic potential, if the management is solely
based upon the PT, INR, platelet count values. |
| first_indexed | 2024-12-24T00:45:27Z |
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| language | English |
| last_indexed | 2024-12-24T00:45:27Z |
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| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-60772843f7a74d68a4298c9d8be143a12022-12-21T17:23:50ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-12-011519151910.7860/JCDR/2021/51085.15802Thromboelastography Parameters Suggestive of Hypercoagulability and its Correlation with Thrombotic Complications in Liver Transplantation- A Retrospective Studysatish logidasan0kanimozhi rathinasamy1gowrishankar anjeneyan2. Associate Professor, Department of Anaesthesiology, Stanley Medical College, Chennai, Tamil Nadu, IndiaSenior Assistant Professor, Department of Anaesthesiology, Government Stanley Medical College, Chennai, Tamil Nadu, IndiaSenior Assistant Professor, Department of Anaesthesiology, Government Stanley Medical College, Chennai, Tamil Nadu, India.Introduction: Conventional coagulation parameters like, Prothrombin Time (PT), International Normalised Ratio (INR) reflects only the synthesis or status of procoagulant factor levels. Whereas, Thromboelastograph (TEG) reflects ongoing coagulation process and helps in identifying hypocoagulable or hypercoagulable status. The hypercoagulable TEG parameters in the perioperative period can guide the physicians to prevent adverse thrombotic complications, instead of depending on the Conventional Coagulation Tests (CCTs), which has the potential to mislead and may delay appropriate clinical interventions. Aim: To establish, if correlation exists between TEG parameters suggestive of hypercoagulability and the occurrence of perioperative thrombotic complications and also to see if CCT correlates with hypercoagulable TEG parameters in liver transplantation. Materials and Methods: This was a retrospective analysis which was done in 32 patients of Diseased Donor Liver Transplantion (DDLT), from August 2018 to September 2019 at tertiary care centre in Chennai, Tamil Nadu, India. Data were analysed for correlation with hypercoagulable TEG parameters and perioperative thrombotic events. Thromboelastograph parameters were also compared with CCT like INR, platelet count. The Mann-Whitney U-test was considered significant if p-value <0.05, at 95% confidence interval. Results: Amongst the aetiology of the transplanted patients (32), the highest number of patients in the present study had alcoholic liver disease {n=11 (34.37%}. A comparison of paired G values with International Normalised Ratio (INR) showed that there was no significant correlation between G value and INR {r= -0.2, p-value=0.47 (Spearman’s rank correlation)}. The G values were compared with platelet counts and a moderate correlation was found (r=0.62, p-value <0.001). The patients with high G traces had platelet counts of normal reference range. There was no correlation between the R time and INR (r-value=0.04), (p-value=0.32). Conclusion: Thromboelastograph parameters suggestive of hypercoagulability can be useful to predict the occurrence of thrombotic complications in liver transplant surgery. The present study found a moderate correlation was seen between the G value in TEG and platelet counts. No correlation was present between r value and INR value. There is always a possibility of aggravating the thrombotic potential, if the management is solely based upon the PT, INR, platelet count values.https://jcdr.net/articles/PDF/15802/51085_CE[Ra1]_F[SH]_PF1(SC_SHU)_PFA(NC)_PN(KM).pdfinternational normalised ratiopoint of care coagulation testsprothrombin timethromboelastographythrombotic complications |
| spellingShingle | satish logidasan kanimozhi rathinasamy gowrishankar anjeneyan Thromboelastography Parameters Suggestive of Hypercoagulability and its Correlation with Thrombotic Complications in Liver Transplantation- A Retrospective Study Journal of Clinical and Diagnostic Research international normalised ratio point of care coagulation tests prothrombin time thromboelastography thrombotic complications |
| title | Thromboelastography Parameters Suggestive of Hypercoagulability and its Correlation with Thrombotic Complications in Liver Transplantation- A Retrospective Study |
| title_full | Thromboelastography Parameters Suggestive of Hypercoagulability and its Correlation with Thrombotic Complications in Liver Transplantation- A Retrospective Study |
| title_fullStr | Thromboelastography Parameters Suggestive of Hypercoagulability and its Correlation with Thrombotic Complications in Liver Transplantation- A Retrospective Study |
| title_full_unstemmed | Thromboelastography Parameters Suggestive of Hypercoagulability and its Correlation with Thrombotic Complications in Liver Transplantation- A Retrospective Study |
| title_short | Thromboelastography Parameters Suggestive of Hypercoagulability and its Correlation with Thrombotic Complications in Liver Transplantation- A Retrospective Study |
| title_sort | thromboelastography parameters suggestive of hypercoagulability and its correlation with thrombotic complications in liver transplantation a retrospective study |
| topic | international normalised ratio point of care coagulation tests prothrombin time thromboelastography thrombotic complications |
| url | https://jcdr.net/articles/PDF/15802/51085_CE[Ra1]_F[SH]_PF1(SC_SHU)_PFA(NC)_PN(KM).pdf |
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