Indian Journal of Anaesthesia

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 65  |  Issue : 4  |  Page : 295--301

Hypercoagulability on thromboelastography after living donor hepatectomy—The true side of the coin


Shankey Garg1, Gaurav Sindwani1, Neha Garg1, Mahesh K Arora1, Viniyendra Pamecha2, Deepak Tempe1 
1 Department of Anaesthesia and Intensive Care, Institute of Liver and Biliary Sciences, New Delhi, India
2 Department of Hepato-pancreato-biliary Surgery and Liver Transplantation, Institute of Liver and Biliary Sciences, New Delhi, India

Correspondence Address:
Gaurav Sindwani
Department of Anaesthesia, Institute of Liver and Biliary Sciences, New Delhi
India

Background and Aims: Coagulation dynamics after donor hepatectomy are complex. Having complete knowledge of the actual changes in the coagulation status during donor hepatectomy is important to prevent complications such as pulmonary embolism, deep vein thrombosis, and bleeding. Hence, the present study aimed to study the coagulation dynamics following open donor hepatectomy both by thromboelastography (TEG) and conventional coagulation tests (CCT). Methods: A total of 50 prospective liver donors were included. TEG and CCT [activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalised ratio (INR), fibrinogen, and platelet counts] were performed for each patient before surgery (baseline), on postoperative day (POD) 0, 1, 2, 3, 5, and 10. Results: TEG showed hypercoagulability in 28%, 38%, 30%, 46%, 42%, and 48% patients; in contrast INR showed hypocoagulability in 58%, 63%, 73%, 74%, 20%, and 0% patients on POD 0,1,2,3,5, and 10, respectively. Patients demonstrating hypercoagulability on TEG had significantly decreased reaction time (P = 0.004), significantly increased maximum amplitude (P < 0.001), and alpha angle value (P < 0.001). Postoperatively, INR, PT, and aPTT values increased significantly, while platelets and fibrinogen levels decreased significantly when compared to their baseline values. There was no coagulation-related postoperative complication in any of the patients. Conclusion: Hypercoagulability after donor hepatectomy is common. TEG showed hypercoagulability and did not show any hypocoagulability as suggested by the CCT. In patients undergoing donor hepatectomy, CCT may not reflect the actual changes incoagulation status and tests such as TEG should be performed to know the correct nature of changes in coagulation following donor hepatectomy.


How to cite this article:
Garg S, Sindwani G, Garg N, Arora MK, Pamecha V, Tempe D. Hypercoagulability on thromboelastography after living donor hepatectomy—The true side of the coin.Indian J Anaesth 2021;65:295-301


How to cite this URL:
Garg S, Sindwani G, Garg N, Arora MK, Pamecha V, Tempe D. Hypercoagulability on thromboelastography after living donor hepatectomy—The true side of the coin. Indian J Anaesth [serial online] 2021 [cited 2021 Jul 29 ];65:295-301
Available from: https://www.ijaweb.org/article.asp?issn=0019-5049;year=2021;volume=65;issue=4;spage=295;epage=301;aulast=Garg;type=0