Effectiveness of Rotational Thormboelastometry Algorithm Guided Transfusion Practice in Living Donor Liver

Background: Liver transplantation is a complicated surgical procedure that involves many complexities such as bleeding and the risk of transfusing blood components. Aim: To investigate the effect of the Rotational Thormboelastometry (ROTEM) algorithm-based blood or blood product transfusion, in clinical outcome of living donor liver transplant (LDLT) patients. Study design: Retrospective study Place and duration of the study: Bahria Town international hospital Lahore from 1st January 2016 to 31st December 2020. Methodology: Sixty patients of living donor liver transplant were enrolled. They were then divided into two groups as per the approved transfusion protocol. The first group named pre-ROTEM and the second was ROTEM group. Initial biochemical features, blood transfusion and patient outcomes were documented. Results: The need for large-scale blood transfusion and transfusion-related products were statistically less in ROTEM group as compared to the pre-ROTEM group. Conclusion: The ROTEM-based algorithms can be used effectively to reduce transfusion of blood components and may increase the chances of early transplant functioning. Keywords: ROTEM algorithm, Blood transfusion, Liver transplant, ASA guideline, Thromboelastogram, TEG