Sarah Bos

94 CHAPTER 6 Results Patient characteristics Of the 60 included patients 20 underwent OLT, 20 had a partial hepatectomy and 20 underwent a PPPD. The main demographic and clinical characteristics of the study population are shown in table 1. Additional clinical characteristics of the patients undergoing OLT are shown in table 2. Almost all the patients had their blood drawn at the planned time points. For 2 OLT patients it was not possible to get a blood sample on the third postoperative day. Eight of the patients who underwent a partial hepatectomy were already discharged before the measurement on day 6 and one of these eight patients declined sampling on day 3. Among the patients who underwent a PPPD, 7 did not have their blood drawn at day 6. In vitro efficacy of pro- and anti-hemostatic agents in samples taken during and after OLT We studied changes in routine hemostatic tests and total thrombin generation in samples taken during OLT. The INR was elevated compared to controls in patients at the start of OLT, and further prolonged during transplantation, with a normalization at post-operative day 6. In addition, plasma fibrinogen and antithrombin levels were lower in patients at the start of surgery, and decreased further during the procedure, with a post-operative normalization (supplementary figure 1). In contrast, patients generatedmore thrombin as compared to controls at each time point, in agreement with our previously published data (supplementary figure 1).(31) We next studied changes in total thrombin generation by in vitro addition of commonly used pro- and anti-coagulant agents. Figure 1 shows absolute ETP values of controls and intraoperative plasma samples in absence or presence of procoagulant agents, and figure 2 the absolute ETP values in the absence and presence of commonly used anticoagulants. Statistical differences indicated are differences in proportional change in ETP upon addition of pro- or anticoagulants betweencontrols andpatients. Inotherwords, these comparisons showwhether an agent has altered pro- or anticoagulant potency in patients compared to controls. Supplementary table 1 shows absolute ETP values and percentual differences between ETP values in the absence and presence of pro- or anticoagulant agents, with significance levels relative to the healthy control group.