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| 1 | Thromboelastographic reference ranges for a cirrhotic patient population undergoing liver transplantation显示文摘AIM To describe the thromboelastography(TEG) 'reference' values within a population of liver transplant(LT) candidates that underline the differences from healthy patients.METHODS Between 2000 and 2013, 261 liver transplant patients with a model for end-stage liver disease(MELD) score between 15 and 40 were studied. In particular the adult patients(aged 18-70 years) underwent to a first LT with a MELD score between 15 and 40 were included, while all patients with acute liver failure, congenital bleeding disorders, and anticoagulant and/or antiplatelet drug use were excluded. In this population of cirrhotic patients, preoperative haematological and coagulation laboratory tests were collected, and the pretransplant thromboelastographic parameters were studied and compared with the parameters measured in a previously studied population of 40 healthy subjects. The basal TEG parameters analysed in the cirrhotic population of liver candidates were as follows: Reaction time(r), coagulation time(k), Angle-Rate of polymerization of clot(α Angle), Maximum strenght of clot(MA), Amplitudes of the TEG tracing at 30 min and 60 min after MA is measured(A30 and A60), and Fibrinolysis at 30 and 60 min after MA(Ly30 and Ly60). The possible correlation between the distribution of the reference range and the gender, age, MELD score(higher or lower than 20) and indications for transplantation(liver pathology) were also investigated. In particular, a MELD cut-off value of 20 was chosen to verify the possible correlation between the thromboelastographic reference range and MELD score. RESULTS Most of the TEG reference values from patients with end-stage liver disease were significantly different from those measured in the healthy population and were outside the suggested normal ranges in up to 79.3% of subjects. Wide differences were found among all TEG variables, including r(41.5% of the values), k(48.6%), α(43.7%), MA(79.3%), A30(74.4%) and A60(80.9%), indicating a prevailing trend to hypocoagulability. The differences between the mean TEG values obtained from healthy subjects and the cirrhotic population were statistically significant for r(P = 0.039), k(P < 0.001), MA(P < 0.001), A30(P < 0.001), A60(P < 0.001) and Ly60(P = 0.038), indicating slower and less stable clot formation in the cirrhotic patients. In the cirrhotic population, 9.5% of patients had an r value shorter than normal, indicating a tendency for faster clot formation. Within the cirrhotic patient population, gender, age and the presence of hepatocellular carcinoma or alcoholic cirrhosis were not significantly associated with greater clot firmness or enhanced whole blood clot formation, whereas greater clot strength was associated with a MELD score < 20, hepatitis C virus and cholestaticrelated cirrhosis(P < 0.001; P = 0.013; P < 0.001).CONCLUSION The range and distribution of TEG values in cirrhotic patients differ from those of healthy subjects, suggesting that a specific thromboelastographic reference range is required for liver transplant candidates. | Lesley De Pietri Marcello Bianchini Gianluca Rompianesi Elisabetta Bertellini Bruno Begliomini | 2016 | World Journal of Transplantation2016，6，3： | 4 |
| 2 | Effect of Italy's motorcycle helmet law on traumatic brain injuries显示文摘 | Servadei F Begliomini C Gardini E | 2003 | Inj Prev2003，9，3： | 1 |
| 3 | The effect of aprotinin on renal function in orthotopic liver transplantation显示文摘 | Molenaar IQ Begliomini B Grazi GL | 2001 | Transplantation2001，71，2： | 1 |
| 4 | The effect of aprotinin on renal function in orthotopic liver transplantation 显示文摘 | Molenaar I Q Begliomini B Grazi G L a al | 2001 | Transplantation2001，71，2： | 1 |
| 5 | The effect aprotinin on renal function in orthotopic liver transplantation显示文摘 | Molenaar IQ Begliomini B Grazi GL | 2001 | Transpl2001，71，2： | 1 |
| 6 | Intraoperative effects of combined versus general anesthesia during major liver surgery 显示文摘 | Siniscalchi A Begliomini B Matteo G | 2003 | Minerva Anestesiol2003，69，12： | 1 |
| 7 | Aprotinin for reducing blood loss and transfusion requirements in orthotopic liver transplantation:a multicentre,randomised,double-blind study显示文摘 | PORTE R J MOLENAAR I Q BEGLIOMINI B | 2000 | Lancet2000，355，： | 1 |
| 8 | Physiological Effects of Strobilurin Fungicides on Plants显示文摘 | VENANCIO W S RODRIGUES M A T BEGLIOMINI E | 2003 | Publication UEPG Ponta Grossa2003，9，3： | 1 |
| 9 | Physiological effects of strobilurin fungicides on plants显示文摘 | VENANCIO W S Rodrigues M A T Begliomini E | 2003 | Publ UEPG Exact Soil Sci Agr Sci Eng Ponta Grossa2003，9，3： | 1 |
| 10 | Aprotinin and transfusion requirements in orthotopie liver trans- plantation: a multicenter randomized double-blind study显示文摘 | Porte RJ Molenaar IQ Begliomini B | 2000 | Lancet2000，355，9212： | 1 |
| 11 | Right ventricular function during orthotopic liver transplantation显示文摘 | De Wolf A M Begliomini B Gasior T A | 1993 | Anesth Analg1993，76，： | 1 |
| 12 | Right ventricular function during orthotopic liver transplantation显示文摘 | DeWolf AM Begliomini B Gasior TA | 1993 | Anesth Analg1993，76，3： | 1 |
| 13 | Pulmonary hypertension as a predictor of postoperative complica- tions and mortality after liver transplantation显示文摘 | De Pietri L Montalti R Begliomini | 2010 | Transplant Proc2010，42，4： | 1 |
| 14 | Single breath diffusing capacity for carbon monoxide: effects of adjustment for inspired volume dead space, carbon dioxide, hemoglobin and carboxyhemoglobin 显示文摘 | Viegi G Baldi S Begliomini E | 1998 | Respiration1998，65，1： | 1 |
| 15 | Aprotinin and transfusion requirements in orthotopic显示文摘 | Porte RJ Molennar IQ Begliomini B | 2001 | Anesthesiology2001，94，： | 1 |
| 16 | Relationships between the volatile compounds evaluated by solid phase microextraction and the thermal treatment of tomato juice: optimization of the blanching parameters显示文摘 | Servili M Selvaggini R Taticchi A Begliomini A L Montedoro G F | 2000 | Food Chemistry2000，71，1： | 1 |
| 17 | Effect of Italy' s motorcycle helmet law on traumatic brain injuries显示文摘 | Servadei F Begliomini C Gardini E | 2003 | Injury Prevention2003，，03： | 1 |
| 18 | Probing the reaching-grasping network in humans through multivoxel pat-tern decoding 显示文摘 | Di Bono MG Begliomini C Castiello U | 2015 | Brain Behav2015，5，00： | 1 |
| 19 | The Use of Intrathecal Morphine for Postoperative Pain Relief After Liver Resection: A Comparison with Epidural Analgesia显示文摘 | Lesley De Pietri Antonio Siniscalchi Alexia Reggiani Michele Masetti Bruno Begliomini Matteo Gazzi Giorgio E. Gerunda Alberto Pasetto | 2006 | Anesthesia & Analgesia2006，，4： | 1 |
| 20 | Thromboelastographic changes in liver and pancreatic cancer surgery: hypercoagulability, hypocoagulability or normocoagulability? 显示文摘 | De Pietri L Montalti R Begliomini B | 2010 | EJA2010，27，7： | 1 |
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