Tissue Plasminogen Activator-Associated Fibrinolysis During Orthotopic Liver Transplantation

Possible mechanism: both increased release of tissue plasminogen activator from endothelial cells and reduced hepatic clearance

A marked increase in fibrinolysis may occur after graft reperfusion and was associated with a decrease in plasminogen activator inhibitor activity.

Clinical features: severe oozing

Laboratory findings:

(1) fall in plasma fibrinogen

(2) increase in fibrin split products

Measures of fibrinolysis:

(1) euglobulin clot lysis time

(2) whole blood clot lysis time by thromboelastography

Severe fibrinolysis defined as both of the following:

(1) euglobulin clot lysis time < 60 minutes

(2) whole blood clot lysis time < 90 minutes