Copyright
©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2016; 22(6): 2005-2023
Published online Feb 14, 2016. doi: 10.3748/wjg.v22.i6.2005
Published online Feb 14, 2016. doi: 10.3748/wjg.v22.i6.2005
Coagulopathy and transfusion therapy in pediatric liver transplantation
Mirco Nacoti, Francesco Fazzi, Ezio Bonanomi, Pediatric Intensive Care Unit, Ospedale Papa Giovanni XXIII Piazza OMS, 24127 Bergamo, Italy
Davide Corbella, Department of Anesthesia, Ospedale Papa Giovanni XXIII, 24127 Bergamo, Italy
Francesca Rapido, Faculty of Medicine, Università Statale di Milano, 20122 Milano, Italy
Author contributions: Nacoti M, Corbella D and Fazzi F reviewed the literature and drafted the manuscript; Rapido F and Bonanomi E revised and approved the final version.
Conflict-of-interest statement: The authors have no conflicts of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mirco Nacoti, MD, Pediatric Intensive Care Unit, Ospedale Papa Giovanni XXIII Piazza OMS, Organizzazione Mondiale della Sanità 1, 24127 Bergamo, Italy. mnacoti@hpg23.it
Telephone: +39-35-2675150 Fax: +39-35-2674989
Received: May 30, 2015
Peer-review started: June 4, 2015
First decision: October 14, 2015
Revised: November 23, 2015
Accepted: December 30, 2015
Article in press: December 30, 2015
Published online: February 14, 2016
Peer-review started: June 4, 2015
First decision: October 14, 2015
Revised: November 23, 2015
Accepted: December 30, 2015
Article in press: December 30, 2015
Published online: February 14, 2016
Core Tip
Core tip: In the last two decades, extensive investigation of abnormalities in hemostasis in adult cirrhotic patients and improvements in both surgical and anesthetic management has enhanced outcome following liver transplantation. Unfortunately, such knowledge cannot be directly applied to pediatric patients, as major differences exist between adults and children undergoing liver transplantation. In this review, we discuss the pattern of hemostatic abnormalities in children with end-stage liver disease, point-of-care coagulation monitoring, and clinical strategies designed to reduce bleeding and thrombosis in pediatric liver transplantation. In conclusion, we propose a prioritized research agenda for this pediatric subspecialty.