The effects of in vitro hemodilution with 6% hydroxyethyl starch (HES) (130/0.4) solution on thrombelastograph analysis in patients undergoing liver transplantation

• Published in: Clinical transplantation Vol. 25; no. 3; pp. 450 - 456
• Main Authors: Bang, Si Ra, Kim, Yoon Hee, Kim, Gaab Soo
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2011; Wiley
• Subjects: 6% HES 130/0.4 (hydroxyethyl starch) solution; Biological and medical sciences; Blood Coagulation - drug effects; End Stage Liver Disease - surgery; end-stage liver disease; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hemodilution; Humans; Hydroxyethyl Starch Derivatives - pharmacology; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical sciences; Middle Aged; Prognosis; Sodium Chloride - pharmacology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; thrombelastograph; Thrombelastography; Tissue, organ and graft immunology; Whole Blood Coagulation Time; Human; Digestive system; Starch; Liver; Patient; Hepatic disease; Terminal stage; Homotransplantation; In vitro; Medicine; end-stage liver disease; Organ preservation; Treatment; Surgery; Analysis; Digestive diseases; Graft; Hemodilution; thrombelastograph; 6% HES 130/0.4 (hydroxyethyl starch) solution; Solution; Liver transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2010.01294.x

Bang SR, Kim YH, Kim GS. The effects of in vitro hemodilution with 6% hydroxyethyl starch (HES) (130/0.4) solution on thrombelastograph analysis in patients undergoing liver transplantation.
Clin Transplant 2011: 25: 450–456. © 2010 John Wiley & Sons A/S. :  Introduction:  The aim of this study was to determine the effects of in vitro hemodilution with 6% HES (130/0.4) solution on thrombelastograph® (TEG) parameters in whole blood samples from patients with end‐stage liver disease (ESLD). Methods:  Enrollment consisted of 95 patients with ESLD undergoing liver transplantation. Blood was diluted by 11%, 22%, and 33% with 6% HES (130/0.4) solution. Normal saline was used as a control diluent. Results:  When blood was diluted by 33% with normal saline, only the reaction time (r) was increased (p < 0.0001) compared to the baseline value. When blood was diluted with 6% HES (130/0.4), 11% dilution decreased maximum amplitude (MA) (p = 0.003) compared to baseline. At 33% dilution, the r (p < 0.0001, vs. baseline) and K (p < 0.0001, vs. baseline; p < 0.0001, vs. normal saline) increased, and the MA, alpha angle, and coagulation index (p < 0.0001, vs. baseline; p < 0.0001, vs. normal saline) decreased. Conclusion:  Hemodilution with 6% HES (130/0.4) solution results in TEG abnormalities even with 11% hemodilution, in whole blood samples of patients with ESLD undergoing liver transplantation.