The Correlation Of Coagulation Disorder And Heparin During The Neohepatic Period Of Orthotopic Liver Transplantation

Objectives:The aim of this study is to discuss the correlation of coagulation disorder and heparin during the neohepatic period of orthotopic liver transplantation.Methods:Thirty-one patients who accepted orthotopic liver transplantation. from the Gan Mei Affiliated Hospital of Kunming Medical University. Their information were collected. The patients, male 26, female 5, from August 2015 to April 2016, ASA physical status Ⅲ or Ⅳ, average age is (47±11) years old. All patients were signed informed consent, and, all of these conformed to the standards of medical ethics, were approved by the hospital ethics committee. The instruments of Thromboelastrography and ACT were used to monitor their blood coagulation status during the paleohepatic phase(T1), the anhepatic phase(T2), the neohepatic period(T3) and before abdomen closure(T4). Retrospectively, we analyze their blood coagulation status during the operation, then, discuss the correlation of coagulation disorder and heparin during the neohepatic period.Results:There were no significant differences in general information, such as age, height, weight (P>0.05). During different four periods, monitoring parameters of TEG(the cup of heparinase):comparison of R, compared with T1,T2, significantly, it was extended at the time of T3 (P<0.05), compared with T3, it was shortened at T4 after regulation (P<0.05); Comparison of MA, compared with T1, MA levels decreased at T2, T3, T4 (P<0.05), then compared with T3, it was increased at T4 (P< 0.05); Comparison of CI, compared with T1, CI levels decreased at T2, T3, T4(P< 0.05). Comparison of ACT:significantly increased ACT levels at T3 compared with T1,T2,T4 (P<0.05), though, there were no significant differences between T1,T2,T4 (P>0.05).Conclusions:The quantity of heparin was increased at the early phase, when the new liver was used. But we can know it as soon as possible by results that TEG and ACT monitored. As relative basis, we can deal with it in good time. So, we can see,it is correlative between coagulation disorder and heparin obviously.