Viscoelastic test based Transfusion management for Liver Transplants

When the cascade model of coagulation was postulated in 1964 it convincingly explained the conventional tests of coagulation and their therapeutic applications for existing anticoagulants. But the conventional tests only tend to measure the procoagulant factors and not the anticoagulant factors present in the blood. This book reviews the current understanding of Cell - based concept of coagulation and suggests an improved method to manage perioperative blood product management during Liver Transplantation based on Viscoelastic tests which more accurately reflect the dynamic interplay between pro and anticoagulants in End stage Liver disease. This approach reduces over transfusion and the resulting harm from excessive coagulation without increasing the risk of perioperative bleeding.