Orthotopic liver transplantation (OLT) remains a potentially haemorrhagic procedure. Thromboelastometry (ROTEM® ) is a point-of-care device used to monitor coagulation during OLT. Whether it allows blood loss and transfusion to be reduced during OLT remains controversial. Excellent correlations and predictive values have been found between ROTEM® parameters and fibrinogen. We hypothesized that the use of a ROTEM® -based transfusion algorithm during OLT would lead to transfusing more fibrinogen and to decreasing bleeding and blood transfusion. Sixty adult patients were consecutively included in a prospective Without-With study: 30 in the group Without ROTEM® results and 30 in the group With ROTEM® -based algorithm. A small and non-significant increase in median fibrinogen transfusion was found in the "With" group (6.0 g versus 4.5 g; p=0.50). It was not associated with a decrease in blood transfusion or in the number of patients exposed to blood products. Liver Transpl , 2014. © 2014 AASLD.

©2014. American Association for the Study of Liver Diseases.