Endogenous Thrombin Potential and Examination of a Further 31 Analytes in Liver Transplant Candidates

• Published in: Transplantation proceedings Vol. 46; no. 6; pp. 2171 - 2176
• Main Authors: Kovacs, F, Gerlei, Zs, Gorog, D, Varga, M, Kobori, L, Gaal, I, Langer, R.M, Beresne, B.L, Sarvary, E
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2014
• Subjects: Adult; Aged; Blood Coagulation - physiology; Blood Coagulation Tests; Female; Humans; Liver Cirrhosis - blood; Liver Cirrhosis - surgery; Liver Transplantation; Male; Middle Aged; Retrospective Studies; Surgery; Thrombin - metabolism; Young Adult
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2014.05.059

Abstract Background To predict the change in patient status and differentation of the basic diseases, endogenous thrombin potential (ETP), clinical chemistry, and coagulation variables were measured in liver transplant–listed patients with different etiologies. Methods Differences in values of ETP and analytes of 30 control persons and 164 cirrhotic patients were examined by means of binary logistic regression. The relationship between the analytes and ETP parameters were analyzed by means of Spearman correlation. The different etiologies of cirrhosises were studied by factor and discriminant analyses. Binary logistic regression was applied to forecast changes in clinical status. Survival analysis was carried out with the appropriate variable. Results International Normalized Ratio and activated partial thromboplastin time values were higher, whereas the area-under-the-curve values were lower in cirrhosis than in healthy subjects. A strong relationship was found only between the peak height and the anti-thrombin III (ATIII) values. In the factor analysis, 3 factors were found, which explained 81.6% of the total variance. Combination of aspartate aminotransferase and ATIII mostly separated the basic disease groups from each other in the discriminant analysis. From 35 variables, the lactate dehydrogenase (LDH) and ATIII have been suited for predicting the change in patient status. Eighty percent of patients with low ATIII and high LDH levels had deterioration of their clinical status. Conclusions Our study demonstrated that the ETP parameters did not provide additional information compared with “conventional” coagulation tests in cirrhosis. On the basis of our study, LDH and ATIII appear to be promising analytes to assess the clinical status of patients with cirrhosis. In our opinion, the classification system of liver transplant–listed patients can be improved with their use.