Mechanisms of coagulopathy in liver transplantation

Abstract

Cirrhotic patients usually present failures in multiple hemostasis components and whose intensity usually follows the aggravation of hepatic insufficiency. In this sense, changes in primary and secondary hemostasis and fibrinolysis may be present. However, to achieve cure for this disease, those patients need undergo the serious challenge of coagulation represented by liver transplantation, even with the previously described fragility. During this surgery, there is an extensive tissue dissection, whose damage can be aggravated by portal hypertension and adhesions. In addition, an unfavorable environment to coagulation, that is, with acidosis, hypocalcemia and hypothermia is common. Together, these and other factors frequently lead to the occurrence of coagulopathy and a demand for hemostasis support measures. Knowing the causes and mechanisms involved in the problem provides greater accuracy to the therapeutic measures chosen.