Table 1.

Methods for assessing bleeding and coagulation in liver transplant

SLT
	Indication	What does it test?	Specimen type	Time to resultsa	Interventions
ABG	Graft function and bleeding	Blood gas concentrations and pH	Arterial whole blood	10–20 min	RBC, bicarbonate
Clauss fibrinogen	Coagulation	Fibrinogen concentration	Plasma	30–45 min	Cryoprecipitate or fibrinogen
CBC	Coagulation and bleeding	Platelet count	Whole blood	30–60 min	Platelet and RBC
INR	Coagulation and graft function	Speed of clotting	Plasma	40–60 min	Plasma, PCC
aPTT	Coagulation	Speed of clotting	Plasma	40–60 min	Plasma, protamine
CMP	Graft injury and graft function	Blood chemistry concentrations; liver and kidney function	Plasma	60–90 min	Graft dysfunction
VET
	Indication	What does it test?	Specimen type	Time to resultsb	Interventions
TEG 5000	Coagulation	Speed of clotting, platelet function, clot strength, and fibrinolysis	Whole blood	First results 5–10 min Last results 60–90 min	Plasma, PCC, protamine, cryoprecipitate, fibrinogen platelets, antifibrinolytic
TEG 6s	Coagulation	Speed of clotting, platelet function, clot strength, and fibrinolysis	Whole blood	First results 5–10 min Last results 60–90 min	Plasma, PCC, protamine, cryoprecipitate, fibrinogen platelets, antifibrinolytic
ROTEM Delta	Coagulation	Clot formation, clot firmness, and clot fibrinolysis	Whole blood	First results 5–10 min Last results 60–90 min	Plasma, PCC, protamine cryoprecipitate, fibrinogen, platelets, antifibrinolytic
ROTEM Sigma	Coagulation	Clot formation, clot firmness, and clot fibrinolysis	Whole blood	First results 5–10 min Last results 60–90 min	Plasma, PCC, protamine cryoprecipitate, fibrinogen, platelets, antifibrinolytic
HemoSonics Quantra	Coagulation	Speed of clotting and clot strength	Whole blood	First results 5–10 min Last results 60–90 min	Plasma, PCC, protamine, cryoprecipitate, fibrinogen, platelets, antifibrinolytic

Abbreviations: ABG, arterial blood glass; CBC, complete blood count; CMP, complete metabolic panel; INR, international normalization of prothrombin time; PCC, prothrombin complex concentrate; aPTT, activated partial thromboplastin time; RBC, red blood cell; ROTEM, rotational thrombelastography; SLT, standard laboratory testing; TEG, thrombelastography; VET, viscoelastic testing.

^aTime to results for SLT are estimated based on clinical experience.

^bTime to results for VET list “first results” which refers to the initial results containing information for clotting time and “last results” which provides data on the lysis parameters.