The Use of ROTEM in Liver Transplant Surgeries: A Luxurious Option or a Necessity?!

Abstract

Blood management in liver transplant surgeries can be challenging. In this article I will address some of the strenuous challenges related to blood management in this patient population and discuss the use of rotational thromboelastometry (ROTEM) to mitigate these challenges. It is well known that patients with liver disease have a rebalanced hemostasis due to the impaired synthesis of both the coagulation factors and pro-coagulant factors. Interestingly, some studies demonstrated an increased endogenous thrombin potential (ETP) in patients with liver cirrhosis [1]. Hence, it is now well known that this group of patients requires special attention when it comes to blood management.