Increased fibrinolysis can occur during orthotopic liver transplant surgery.
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
(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
To read more or access our algorithms and calculators, please log in or register.
Specialty: Hematology Oncology, Gastroenterology