Thromboelastographic description of intraoperative coagulopathy in patients undergoing liver transplant surgery: A single-center observational study

doi:10.5500/wjt.v16.i2.118880

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World Journal of Transplantation

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2220-3230

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Transplant. Jun 18, 2026; 16(2): 118880
Published online Jun 18, 2026. doi: 10.5500/wjt.v16.i2.118880

Thromboelastographic description of intraoperative coagulopathy in patients undergoing liver transplant surgery: A single-center observational study

Wissam Maroun, Zachary F Osborn, Paras Garg, Santhalakshmi Angappan, Jaber El-Bashir, Olivia Heppell, James Soetedjo, Srikanth Pillai, Katsunori Miyake, Adhnan Mohamed, Shunji Nagai, Carlos E Guerra-Londono

Wissam Maroun, Zachary F Osborn, Paras Garg, Santhalakshmi Angappan, Jaber El-Bashir, Olivia Heppell, James Soetedjo, Srikanth Pillai, Carlos E Guerra-Londono, Department of Anesthesiology, Pain Management & Perioperative Medicine, Henry Ford Hospital, Henry Ford Health, Detroit, MI 48202, United States

Katsunori Miyake, Adhnan Mohamed, Shunji Nagai, Division of Transplant and Hepatobiliary Surgery, Department of Surgery, Henry Ford Hospital, Henry Ford Health, Detroit, MI 48202, United States

Author contributions: Maroun W wrote the initial draft; Maroun W, Osborn ZF, Garg P, Angappan S, El-Bashir J, Heppell O, Soetedjo J, Pillai S, Miyake K, Mohamed A, Nagai S, Guerra-Londono CE reviewed and edited the manuscript; Osborn ZF performed the statistical analysis; Heppell O, Soetedjo J, Pillai S, and Miyake K participated in data collection. All authors approved the final manuscript.

Institutional review board statement: The study was approved by the Institutional Review Board of Henry Ford Health (Approved No. 15528-01) and conformed to both the Declaration of Helsinki and Declaration of Istanbul ethical guidelines.

Informed consent statement: The need for informed consent was waived due to the retrospective nature of the study.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author.

Corresponding author: Carlos E Guerra-Londono, MD, Department of Anesthesiology, Pain Management & Perioperative Medicine, Henry Ford Hospital, Henry Ford Health, 2799 West Grand Boulevard, Detroit, MI 48202, United States. cguerra1@hfhs.org

Received: January 13, 2026
Revised: February 8, 2026
Accepted: March 13, 2026
Published online: June 18, 2026
Processing time: 136 Days and 15.4 Hours

Core Tip

Core Tip: This study describes intraoperative coagulation abnormalities across different phases of liver transplantation using thromboelastography. Findings highlight that coagulopathy peaks during the anhepatic and post-reperfusion phases, primarily driven by platelet dysfunction, underscoring the importance of targeted transfusion and antifibrinolytic strategies to optimize hemostatic management during these critical stages.