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Postoperative coagulopathy after live related donor hepatectomy: Incidence, predictors and implications for safety of thoracic epidural catheter.
- Source :
- Journal of Postgraduate Medicine; Jul-Sep2015, Vol. 61 Issue 3, p176-180, 5p
- Publication Year :
- 2015
-
Abstract
- Background: Coagulopathy after living donor hepatectomy (LDH) may endanger donor safety during removal of thoracic epidural catheter (TEC). The present study was conducted to evaluate the extent and duration of immediate postoperative coagulopathy after LDH. Materials and Methods: A retrospective analysis of perioperative record of LDH over three years was conducted after IRB approval. Variables such as age, gender, BMI, ASA classification, liver volume on CT scan, preoperative and postoperative INR, platelet count (PC) and ALT of each donor for five days was noted. In addition, duration of surgery, remnant as percentage total liver volume (Remnant%), blood loss, day of peak in PC and INR were also noted. Coagulopathy was defined as being present if INR exceeded 1.5 or platelet count fell below 1 x 10<subscript>5</subscript>/mm³ on any day. Data was analyzed using SPSS 20 for Windows. Between group comparison was made using the Student 't' test for continuous variables and chi square test for categorical variables. Univariate analysis was done. Multiple logistic regression analysis was used to find independent factor associated with coagulopathy. Results: Eighty four (84) donors had coagulopathy on second day (mean INR 1.9 ± 0.42). Low BMI, % of remnant liver and duration of surgery were independent predictors of coagulopathy. Right lobe hepatectomy had more coagulopathy than left lobe and low BMI was the only independent predictor. There was no correlation of coagulopathy with age, gender, blood loss, presence of epidural catheter, postoperative ALT or duration of hospital stay. High INR was the main contributor for coagulopathy. Conclusions: Coagulopathy is seen after donor hepatectomy. We recommend removal of the epidural catheter after the fifth postoperative day when INR falls below 1.5. [ABSTRACT FROM AUTHOR]
- Subjects :
- BLOOD coagulation disorders
HEMORRHAGE
HEPATECTOMY
LENGTH of stay in hospitals
MULTIVARIATE analysis
ORGAN donors
PATIENT safety
REGRESSION analysis
SURGICAL complications
BODY mass index
RETROSPECTIVE studies
EPIDURAL catheters
DATA analysis software
DESCRIPTIVE statistics
PLATELET count
BLOOD disease treatment
Subjects
Details
- Language :
- English
- ISSN :
- 00223859
- Volume :
- 61
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Journal of Postgraduate Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 103650194
- Full Text :
- https://doi.org/10.4103/0022-3859.159419