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Association of acid-base balance disorders with coagulation disorders and transfusional need during liver transplantation

Grant number: 18/24124-4
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): April 01, 2019
Effective date (End): March 31, 2020
Field of knowledge:Health Sciences - Medicine
Principal researcher:Fernanda Loureiro de Andrade Orsi
Grantee:Júlia Ruete de Souza
Home Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Orthotropic liver transplantation (TOF) is one of the main therapeutic options for the terminal liver treatment of different etiologies, such as progression of complications, primary liver neoplasms, acute liver failure and metabolic diseases. Despite is healer, TOF may evolve due to complications such as acid-base and coagulopathy. Coagulopathy may lead to increased transfusion, which further compromises the prognosis of TOF. The association of acid-base with coagulopathy and transfusion is well studied in cases of severe polytrauma. However, this association is not anchored in TOF. The objective is to evaluate the association of metabolic acidosis with coagulation and transfusion disorders during the intraoperative period of TOF. The primary objective is to evaluate the association between values of excess blood base (BE) and fibrinogen values. The secondary objectives are to evaluate the association of BE, pH and lactate with activated partial thromboplastin time (aPTT), prothrombin time (PT), platelets and hemoglobin (Hb); as well as the association of BE, pH and lactate values with the total amount of blood components used during surgery. To do this we will carry out a cohort study, with a retrospective survey of diagnostic data, demographic data of the treatment, pre-transplantation exams, hepatic pre-reperfusion and hepatic post reperfusion and on complications of all patients undergoing liver transplantation at Hospital de Clinics of the University of Campinas (UNICAMP), from August 1, 2016 to January 1, 2018. To determine the association between acid-base disorders, coagulation and transfusional need, we will use linear regression models having the values of acid-base parameters as determinant variables and laboratory (coagulation) and clinical (transfusion) outcomes as dependent variables.

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
DE SOUZA, JULIA RUETE; YOKOYAMA, ANA PAULA; MAGNUS, MARIANA MUNARI; BOIN, ILKA; DE ATAIDE, ELAINE CRISTINA; MUNHOZ, DERLI CONCEICAO; PEREIRA, FABRICIO BISCARO; LUZO, ANGELA; ORSI, FERNANDA ANDRADE. Association of acidosis with coagulopathy and transfusion requirements in liver transplantation. JOURNAL OF THROMBOSIS AND THROMBOLYSIS, . (16/14172-6, 18/24124-4)

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