Perioperative Coagulation Management in Liver Transplant Recipients

We review contemporary coagulation management for patients undergoing liver transplantation. A better understanding of the complex physiologic changes that occur in patients with end-stage liver disease has resulted in significant advances in anesthetic and coagulation management. A group of internationally recognized experts have critically evaluated current approaches for coagulopathy detection and management. Strategies for blood component and factor replacement have been evaluated and recommended therapies proposed. Pharmacologic treatment and prevention of coagulopathy, management of patients receiving antiplatelet medications, and the role of transesophageal echocardiography for early detection and management of thromboses are presented. Corresponding Author: Dmitri Bezinover MD., PhD, Associate Professor of Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Penn State Hershey Medical Center, Penn State College of Medicine, 500 University Drive, P.O. Box 850, Hershey, PA 17033-0850 Authorship Dmitri Bezinover: Participated in research design, participated in the performance of the research; participated in writing, correction, and preparation of the final version of the manuscript. Daniel Dirkmann: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. James Findlay: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. Cosmin Guta: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. Matthias Hartmann: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. Ramona Nicolau- Raducu: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. Ahmed M. Mukhtar: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. Marina Moguilevitch: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. Evan Pivalizza: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. David Rosenfeld: Participated in research design, participated in the performance of the research, participated in the writing and correction of the manuscript. Fuat Saner: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. Christopher Wray: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. Gebhardt Wagener: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. James West: Participated in research design, participated in the performance of the research, participated in writing and correction of the manuscript. Disclosure: Dr. Fuat Saner has received honoraria for presentations not related to this project from the following companies: CSL Behring, TEM International, Biotest, Gilead, and AstraZeneca, MSD. Dr. Matthias Hartmann has received an unrestricted grant for data analyses from CSL Behring GmbH, Marburg, Germany. All other authors declare no competing interests. Funding: Authors did not receive any financial support for this work. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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