Effects of different concentrations of heparin in the preservation solution on blood coagulation after reperfnsion in patients undergoing orthotopic liver transplantation / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effect of different concentrations of heparin in the cold preservation solution on blood coagulation after reperfusion during orthotopic liver transplantation ( OLT) . Methods Forty ASA Ⅱ or Ⅲ patients with end-stage liver disease (31 males, 9 females) weighing 51-82 kg undergoing OLT were randomly divided into 3 groups according to the concentrations of heparin in the liver preservation solution group Ⅰ 2 000 U?L-1( n = 14); group Ⅱ 8000 U?L-1(n= 12) and group Ⅲ 20 000 U?L-1(n = 12) .Anesthesia was induced with propofol, fentanyl and rocuronium and maintained with isoflurane inhalation and intermittent i.v. boluses of fentanyl. Body temperature was maintained at 35.5-37.5℃ and Hct at 22%-35% . Blood samples were taken from central vein at 15 min before reperfusion (T0,baseline) and 5, 30, 60, 120 and 180 min of reperfusion (T1-5) for determination of ACT, CR and platelet function (PF) using Sonoclot platelet function and coagulation analyzer (U.S.A.). Blood concentration of heparin was determined in 3-4 patients in each group at T0-5 ( HPLC) . Results The 3 groups were comparable with respect to age, body weight, ASA physical status and Child classification. The glass ball activated coagulation time (gbACT) was significantly prolonged at T1-4 in group Ⅲ and at T1,2 in group Ⅱ as compared to the baseline values at T0 ( P