Relationship Between Different Threshold Values Of Preoperative Thromboelastogram And Blood Use In Liver Transplantation Patients

Objective: to evaluate the relationship between preoperative thromboelastic parameters and the amount of blood used in liver transplantation patients,and to guide the preoperative formulation of individual plans to improve the prognosis of patients.Methods:a retrospective analysis of our hospital between Junary 2019 and september 2019,the clinical data of 8 patients with liver transplantation surgery,intraoperative infusion concentration of red blood cells divided into blood transfusion group(MBT)and not blood transfusion group(NBT),using SPSS software for statistical analysis,and carries on the comparison to two groups of preoperative indicators,and using Logistic regression analysis to evaluate the risk factors of intraoperative massive blood transfusion.The ROC curve was used to evaluate the predictive value of thromboelastic charts for massive intraoperative transfusion.Results: among the 8 patients with liver transplantation,4patients had blood transfusion.Univariate analysis showed that the internationally standardized prothrombin ratio(P=0.003),partial thrombin time(P=0.037),platelet count(P=0.007),Angle a(P=0.014),and MA(P<0.001)were risk factors for massive transfusion in liver transplantation patients.Multiple Logistic regression analysis showed that INR(OR=3.413,95%CI 1.133-10.285),PLT(OR=3.143,95%CI 0.901-10.975),Angle a(OR=5.314,95%CI 1.227-23.083),and MA(OR=8.751,95%CI 2.935-26.067)were independent risk factors for massive blood transfusion in liver transplantation patients.Under the ROC curve,MA critical value <46mm,area under the curve was 0.907(95%CI:0.875~0.939),sensitivity was 92.0%,specificity was 80.8%,with high predictive value.The critical value of INR was >2.3,the AUC under the curve was 0.803(95%CI0.751~0.853),the sensitivity was 50.0%,and the specificity was 25.0%.The critical valueof PLT was <81×109/L,the area under the curve was 0.785(95%CI 0.727~0.841),75.0%,and the specificity was 50.0%.The critical value of a Angle was <40°,the area under the curve was 0.761(95%CI 0.705 ~ 0.813),the sensitivity was 50.0%,and the specificity was 25.0%.Conclusion: thromboelastic diagram can play an important role in the preoperative evaluation of liver transplantation,and can predict the blood used during the operation.