Observational studyClinical transplantation2025
Hyperfibrinolysis Detection During Liver Transplantation Using Viscoelastometry.
Observational study in Clinical transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- ClotPro viscoelastic testing in coagulation disorders in dogs: a retrospective analysis.Journal of veterinary internal medicine · 2026Article
- Phase-specific dynamics of coagulation factors V, VIII, and XIII during liver transplantation: insights from a prospective study.Perioperative medicine (London, England) · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnd-stage liver disease induces a precarious hemostatic equilibrium, named rebalanced hemostasis. Liver transplantation additionally causes profound disturbances in the hemostatic balance. Hyperfibrinolysis poses a relevant impairment to the coagulation process during liver transplantation. During surgery, the hemostatic management is guided by viscoelastic monitoring systems. The aim of this prospective, observational study was to evaluate the incidence of hyperfibrinolysis during liver transplantation using different viscoelastic assays, namely an ecarin-based test and a tissue factor-based test.
methodsBlood sampling was done at five measurement time points during liver transplantation (T1 induction of general anesthesia, T2 start of anhepatic phase, T3 end of anhepatic phase, T4 10 min after reperfusion, T5 end of surgery). Viscoelastic testing included ClotPro assays EX-test, FIB-test, AP-test, and ECA-test. Hyperfibrinolysis was defined as a maximum lysis of at least 15%. Lysis detection time (LDT) served as an indicator for the velocity of lysis, marking the time point when less than 85% of the clot are extant.
resultsThirty transplantation surgeries were included. A total of 150 viscoelastic measurements have been performed. The ECA-test detected hyperfibrinolysis significantly more often (31 [21%] vs. 22 [15%] out of 150, p = 0.039) and in a higher number of patients than the EX-test. The ECA-test revealed hyperfibrinolysis significantly earlier compared to the EX-test (median LDT 2100 s [1500/2900] vs. 3300 s [2400/3800], p < 0.001).
conclusionThis study demonstrates higher sensitivity of the ecarin-test than the tissue-factor-test in monitoring hyperfibrinolysis, with more frequent and earlier detection of this coagulopathy.
trial registrationGerman Clinical Trials Register: DRKS00032827.
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