Publications by authors named "Hugo D Viso"

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Intraoperative Hemostatic Management of a Cardiohepatic Transplant With Rotational Thromboelastometry: A Case Report.

A A Pract 2020 Dec;14(14):e01358

From the Department of Anesthesia, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.

Cardiohepatic transplantation represents a double hemostatic challenge. Given the absence of specific guidelines and current evidence, we designed a 5-step approach based on rotational thromboelastometry (ROTEM). A 60-year-old male patient with cirrhosis and myocarditis underwent a 9-hour transplantation. Bleeding occurred after weaning from extracorporeal circulation. Evidence of reduced clot strength triggered fibrinogen and platelet replacement therapy. During liver transplant, only hemoglobin optimization was necessary. In conclusion, hemostatic management protocols for cardiohepatic transplants should consider the specific coagulopathy mechanisms underlying each surgical phase. Because whole blood testing is essential for their diagnosis, we recommend using ROTEM for optimal coagulation management.
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December 2020