Bleeding problems in patients undergoing segmental liver transplantation

Abstract

Liver transplantation is associated with a great risk of bleeding, which is of both surgical and medical etiopathogenesis. All phases of the transplantation are characterized by a complicated and continuously evolving derangement of pro- and anticoagulant factors, which result in coagulopathy. The magnitude of this coagulopathy varies between patients and therefore must be corrected on an individual basis. During the different phases of the transplantation, treatment must be targeted with the aim of controlling the bleeding according to its pathogenesis. This paper analyzes the problems associated with the monitoring and correction of coagulation during the different phases of liver transplantation, with specific focus on the idiosyncrasies of segmental liver transplantation. (C) 2000 Lippincott Williams and Wilkins.