Sarah Bos

91 Efficacy of pro- and anticoagulant strategies in plasma 6 consecutive adult patients who were scheduled for OLT, partial hepatectomy, or pylorus preserving pancreatico-duodenectomy (PPPD), who had given written informed consent were included in this study. Twenty patients per group were recruited. Exclusion criteria were: age below 18 years, acute liver failure, hereditary thrombophilia or hemophilia, use of vitamin K antagonists, transfusion of blood products ( < 7 days), deep vein thrombosis ( < 30 days), pregnancy and HIV positivity. To establish reference values for the various laboratory tests employed, blood samples of 42 healthy individuals were utilised. Exclusion criteria for healthy volunteers were similar to those applied in patients with addition of systemic diseases requiring clinical intervention or follow-up, the use of anticoagulant medications, history of venous thromboembolic events, and blood (product) transfusion up to seven days prior to inclusion. The study was approved by NRES Committee London – Westminster, Study Number 17/LO/0527. Blood samples Blood samples for analyses were taken into 3.2% sodium citrate tubes at the time points indicated below. Samples were drawn by venepuncture from controls and in the post-operative period using a 21Gneedle usingminimal stasis. Intraoperatively, blood was drawn from non-heparinised indwelling vascular catheters already placed by the anaesthesiologist. The citrate tube was always taken after taking a serum or EDTA tube that was used for routine diagnostic testing. In those patients receiving post-operative thromboprophylaxis, post-operative samples were taken just before administration of LMWH. Liver transplantation Partial hepatectomy and PPPD* 1 2 3 4 5 6 7 After induction of anesthesia 30 minutes after the start of the anhepatic phase 30 minutes after reperfusion At the end of surgery Post-operative day 1 Post-operative day 3 Post-operative day 6 After induction of anesthesia At the end of surgery Post-operative day 1 Post-operative day 3 Post-operative day 6 *pylorus preserving pancreatico-duodenectomy Blood samples were directly taken from the operating theatre or clinical ward to the laboratory by the clinical investigators (SB and BvdB) who immediately processed the samples. Platelet-poor plasma was obtained by centrifuging blood samples at 18°C for 10 minutes at 2,000g and subsequently for 10 minutes at 10,000g within 30 minutes after blood collection. Plasma samples were then