Abstract:Cardiohepatic transplantation represents a double hemostatic challenge. Given the absence of specific guidelines and current evidence, we designed a 5-step approach based on rotational thromboelastometry (ROTEM). A 60-year-old male patient with cirrhosis and myocarditis underwent a 9-hour transplantation. Bleeding occurred after weaning from extracorporeal circulation. Evidence of reduced clot strength triggered fibrinogen and platelet replacement therapy. During liver transplant, only hemoglobin optimization … Show more
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