TY - JOUR T1 - COagulation during and after orthotopic transplantation of the human liver AU - Groth CG, Pechet L, Starzl TE Y1 - 1969/01/01 N1 - 10.1001/archsurg.1969.01340070049006 JO - Archives of Surgery SP - 31 EP - 34 VL - 98 IS - 1 N2 - In earlier reports from this institution1,2 changes in hemostasis were described in five patients treated with orthotopic homotransplantation of the liver. There was an intraoperative bleeding diathesis at the same time as fibrinolysis and hypofibrinogenemia developed. In four of the cases, the hemorrhage was eventually controlled after the administration of epsilon aminocaproic acid (EACA), fibrinogen, and fresh blood. Subsequently, three of the four survivors formed thrombi at or near femoral venotomy sites which had been used for the insertion of external bypass catheters; in all three, the eventual result was multiple pulmonary embolization.Appreciation of the seriousness of these problems prompted a number of investigations to be performed in dogs and pigs2-5 to more fully characterize the clotting abnormalities of liver transplantation and to learn if a succeeding period of hypercoagulability was an inherent part of the picture. It has been established from these studies that hepatic homotransplantation SN - 0004-0010 M3 - doi: 10.1001/archsurg.1969.01340070049006 UR - http://dx.doi.org/10.1001/archsurg.1969.01340070049006 ER -