Background: Lung transplantation surgery is often performed on extracorporeal membrane oxygenation (ECMO) which is generally associated with coagulopathy and bleeding. Fresh frozen plasma (FFP) might be a source of clotting factors to support coagulation but on the other hand it may be associated with higher morbidity and mortality of patients in general.

Aims: The aim of this study was to find out whether point of care (POC) approach to diagnosis of perioperative coagulopathy may decrease consumption of FFP and whether it will impair secondary hemostasis measured by ROTEM.

Methods: In this randomized study, 40 patients undergoing lung transplantation (most of them done on ECMO) were analyzed. Twenty patients were treated using standard approach based on administering of FFP during bleeding (non POC group) and 20 patients were treated on the base of POC tests (POC group) such as ROTEM (administering prothrombin complex concentrate, platelets, fibrinogen). ROTEM (EXTEM, FIBTEM and INTEM) exam was performed before and after surgery in both groups.

Results: In POC group no FFP was administered during lung transplantation surgery. This approach actually enabled ,,plasma free” perioperative management. There was no significant difference (p < 0.05), shown on Fig 1 and 2, between both groups after surgery in results of ROTEM.

Conclusions: “Plasma free” perioperative approach to bleeding during lung transplantation surgery does not seem to cause secondary hemostasis pathology measured by ROTEM.
Acknowledgement: The study was supported by Supported by Ministry of Health, Czech Republic – conceptual development of research organization, Motol Univesity Hospital, Prague,Czech Republic 00064203.

[Fig 1]

[Fig 2]

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/plasma-free-perioperative-approach-during-lung-transplantation-does-not-seem-to-impair-secondary-hemostasis-measured-by-rotem/