Yoon U, Bartoszko J, Bezinover D, et al.; ERAS4OLT.org Working Group. Intraoperative transfusion management, antifibrinolytic therapy, coagulation monitoring and the impact on short-term outcomes after liver transplantation-A systematic review of the literature and expert panel recommendations. Clin Transplant. 2022;36:e14637.
Guideline Recommendation:
Viscoelastic testing (VET) has a strong advantage in characterizing the complex coagulopathy of liver disease over conventional coagulation tests, which is often poorly correlated with clinical bleeding and thrombotic complications. It is likely that VET-guided transfusion algorithms are associated with reductions in allogenic blood products. VET is highly unlikely to cause adverse outcomes or patient harm. The overall balance of costs and benefits favors VET-guided management by reductions in the use of allogeneic blood products.