A comparative study of rotational thromboelastometry-guided versus conventional blood transfusion in cirrhotic patients with hepatocellular carcinoma undergoing transarterial chemoembolization (TACE) or radiofrequency tumor ablation (RFA) at Siriraj hospital rotational thromboelastometry, transarterial chemoembolization, radiofrequency tumor ablation
Conditions
Interventions
rotational thromboelastometry-guided blood transfusion
Experimental Procedure/Surgery
Sponsors
Transmedic (Thailand)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Aged 18 years or older 2. Have liver cirrhosis (of any etiology) which is biopsy proven or defined by any two or more of the following: fibroscan reading > 12.5 kPa, ultrasound features of cirrhosis, evidence of portal hypertension on imaging and/or presence of varices, compatible clinical features 3. Have been diagnosed with hepatocellular carcinoma 4. Planned for transarterial chemoembolization (TACE) or tumor radiofrequency ablation (RFA) 5. Thrombocytopenia with a platelet count (50 x 109/L) and/or coagulopathic based on INR > 1.5 6. Able and willing to provide informed consent 7. Able to speak and understand Thai
Exclusion criteria
Exclusion criteria: 1. Have been diagnosed with other congenital or acquired coagulation disorders 2. Patients on anticoagulant medications (e.g. low-molecular weight heparin, warfarin, enoxaparin, rivaroxaban, dabigatran, apixaban) who have not stopped at least 5 days prior to the procedure 3. Patients on antiplatelet medications (e.g. aspirin, clopidogrel) who have not stopped at least 5 days prior to the procedure 4. Patients in whom it is difficult to obtain blood sample due to venous access difficulties 5. Have other active malignancies (except hepatocellular carcinoma) 6. Patients who have received FFP, platelet transfusion, cryoprecipitate in the week prior 7. Patients with active sepsis 8. Patients with history of platelet alloantibody
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| amount of blood products 1 day before intervention Number | — |
Secondary
| Measure | Time frame |
|---|---|
| rates of procedure-related bleeding 24 hours after procedure Number,rates of transfusion reactions 24 hours after procedure Number,rates of procedure-related non-bleeding complications 24 hours after procedure Number,hospital length of stay after procedure Day(s),cost of treatmen Before and after procedure Number | — |
Countries
Thailand
Contacts
Public ContactKittitat Chiaranairungrot
Faculty of Medicine, Siriraj Hospital
Outcome results
None listed