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Magnesium therapy improves thromboelastographic findings before liver transplantation: a preliminary study

[Un traitement au magnésium améliore les résultats thromboélastographiques avant la transplantation hépatique : une étude préliminaire]

From the Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea.

Address correspondence to: Dr. Jaemin Lee, Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Kangnam Saint Mary’s Hospital, 505 Banpo-Dong, Seocho-Gu, Seoul, Korea 137-040. Phone: 82-2-590-1545; Fax: 82-2-537-1951; E-mail: jmlee{at}catholic.ac.kr

Purpose: Patients undergoing liver transplantation may be predisposed to hypomagnesemia and present a bleeding tendency. There are evidences suggesting that magnesium is a crucial constituent of the blood coagulation cascade and has a pro-coagulant activity. The aim of this study was to investigate the effect of magnesium therapy on thromboelastography (TEG) in patients undergoing liver transplantation.

Methods: 27 patients scheduled for liver transplantation were enrolled. 1.5 g of magnesium sulfate, diluted in normal saline, were infused to all patients over five minutes in the operating room, before skin incision. The TEG findings immediately before and ten minutes after the magnesium infusion were compared.

Results: The TEG findings showed general hypocoagulability before magnesium therapy. The K time and coagulation times (r+k) were shortened significantly from 641.6 ± 505.9 (mean ± SD) to 464.6 ± 387.7 sec and from 1664.7 ± 772.5 to 1362.2 ± 487.1 sec respectively (P < 0.05); the maximal amplitude, and TEG index showed significant increases from 38.5 ± 13.5 to 45.3 ± 12.2 mm and from –3.4 ± 2.6 to –1.9 ± 1.8 respectively after magnesium therapy (P < 0.01). R time, alpha angle and LY60 were not different after magnesium therapy.

Conclusion: Magnesium therapy significantly improved TEG findings suggestive of a general hypocoagulable state towards normal in patients about to receive liver transplantation.

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