الفهرس 
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Abstract
Heparin like effect (HLE) can affect coagulation variably during live donor liver transplant (LDLT). Primary aim is tomonitor the perioperative incidence and severity of HLE with rotational thromboelastometry (ROTEM) and conventional coagulation tests (CCT) in our center.
This is a diagnostic clinical trial among recipients (2015-2017) (Pan African Clinical Trial Registry PACTR201712002839259). No heparin were given prior to surgery and liver donor vessels were flushed prior to insertion. Heparin was infused (60-180 U/kg/day) postoperatively for 2 days and then was replaced by low molecular weight heparin (LMWH) (20 mg/12 h). ROTEM and SLT were performed pre-operative, anhepatic, post-reperfusion, and on post-operative day (POD) 1, 3 and 7. ROTEM subtypes includes EXTEM, INTEM and HEPTEM representing intrinsic, extrinsic coagulation pathways and heparinase enzyme respectively. HLE is identified when CT INTEM is >240 sec and CT INTEM/CT HEPTEM >1.25. SLT tests represented by Prothrombin time (sec) (PT) and activated partial thromboplastin (sec) (aPTT). ROTEM was used to guide blood transfusion
Results of this study demonstrated that39 recipients (1 excluded) included were 49.53±6.11 years old, Liver graft weight was 781.00±107.0 gm, operative duration 11.00±2.0 h, MELD 15.00±3.0. No blood was transfused in 26.32%, n=10 with ROTEM guidance. Prolonged CT INTEM was observed in7 (18.42%) during theanhepatic phase (range: 257-1523 sec), in 19 (50%) at 5 min post-reperfusion(range: 270-3312 sec)and extended in 31.58%, n=12in postoperative day 1 with heparin infusion (range: 257-344 sec). No HLE was ROTEM identified with LMWH. Severe CT prolongation (HLE)was identified in 6 patients out of 7 in the anhepatic phase (15.79% of total), this was associated with a high a percentage of morbidity (>50%) and mortality (2 failed to survive).Total 3 month survival was 78.9%, n= 30 and mortality, 21.1%, n=8. Weak correlation existed between aPTT and CT INTEM (r=0.12,