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| 1 | Hemostasis in liver transplantation:Pathophysiology,monitoring,and treatment显示文摘Recent findings in the pathophysiology and monitoring of hemostasis in patients with end stage liver disease have major impact on coagulation management during liver transplantation. There is increasing evidence, that the changes in both coagulation factors and platelet count regularly observed in patients with liver cirrhosis cannot be interpreted as a reliable indicator of diffuse bleeding risk. Instead, a differentiated view on hemostasis has led to the concept of a rebalanced coagulation system: While it is important to recognize that procoagulant factors are reduced in liver cirrhosis, it is also evident that synthesis of anticoagulant factors and fibrinolytic proteins produced in the liver is also diminished. Similarly, the decreased platelet count may be counterbalanced by increased platelet aggregability caused by highly active von Willebrand multimeres. The coagulation system is therefor stated to be rebalanced. While under normal 'unstressed' conditions diffuse bleeding is rarely observed, however both diffuse bleeding or thrombus formation may occur when compensation mechanisms are exhausted. While most patients presenting for liver transplantation have severe cirrhosis, liver function and thus production of pro- and anticoagulant factors can be preserved especially in cholestatic liver disease. During liver transplantation, profound changes in the hemostasis system can occur. Surgical bleeding can lead to diffuse bleeding as coagulation factors and platelets are already reduced. Ischemia and tissue trauma can lead to alterations of hemostasis comparable to trauma induced coagulopathy. A further common disturbance often starting with the reperfusion of the transplanted organ is hyperfibrinolysis which can eventually precipitate complete consumption of fibrinogen and an endogenous heparinization by glycocalyx shedding. Moreover, thrombotic events inliver transplantations are not uncommon and contribute to increased mortality. Besides conventional laboratory methods, bed-side monitoring of hemostasis(e.g., thrombelastography, thrombelastometry) is often used during liver transplantation to rapidly diagnose decreases in fibrinogen and platelet count as well as hyperfibrinolysis and to guide treatment with blood products, factor concentrates, and antifibrinolytics. There is also evidence which suggests when algorithms based on bed-side hemostasis monitoring are used a reduction of blood loss, blood product use, and eventual mortality are possible. Notably, the bed-side monitoring of anticoagulant pathways and the thrombotic risk is not possible at time and thus a cautious and restrictive use of blood products is recommended. | Matthias Hartmann Cynthia Szalai Fuat H Saner | 2016 | World Journal of Gastroenterology2016，22，4： | 11 |
| 2 | Liver transplantation and neurological side effects显示文摘 | Fuat H. Saner Silvio Nadalin Arnold Radtke Georgios C. Sotiropoulos Gernot M. Kaiser Andreas Paul | 2009 | Metabolic Brain Disease2009，，1： | 2 |
| 3 | Effects of positive end-expiratory pressure on systemic haemodynamics, with special interest to central venous and common iliac venous pressure in liver transplanted patients显示文摘 | Saner FH Pavlakovic G Gu Y et at | 2006 | Eur J Anaesthesiol2006，23，9： | 1 |
| 4 | Does PEEP impair the hepatic outflow in patients following liver transplantation?显示文摘 | Saner FH Pavlakovic G Gu Y | 2006 | Intensive Care Med2006，32，10： | 1 |
| 5 | Angiogenesis: prognostic and therapeutic impli- cations in gynecologic and breast malignancies 显示文摘 | Saner G Deissler H | 2003 | Curr Opin Ob- stet Gynecol2003，15，1： | 1 |
| 6 | Melanin as an adsorbent for drug residues 显示文摘 | Howells L Godfrey M Saner MJ | 1994 | Analyst1994，119，： | 1 |
| 7 | Diagenesis of the Safa- niya Sandstone Member(mid-Cretaceous) in Saudi Arabia显示文摘 | Cagatay M N Saner S A1Saiyed I | 1996 | Sedimentary Geology1996，105，34： | 1 |
| 8 | The essence on mass spectrometry based micro- bial diagnostics显示文摘 | Kliem M Saner S | 2012 | Curt Opin Microbiol2012，15，3： | 1 |
| 9 | Outcomes of patients with definite and suspected isolated cardiac sarcoidosis treated with an implantable cardiac defibrillator 显示文摘 | Kron J Saner W Mueller G | 2015 | J Interv Card Eleclrophysiol2015，43，1： | 1 |
| 10 | Ageing behavior of electrochemical double layer capacitors 显示文摘 | Bohlen O Kowal J Saner D U | 2007 | Journal of Power Sources2007，172，1： | 1 |
| 11 | Role of contrast enhanced US in the evaluation of renal tumors显示文摘 | Roy C Gengler L Saner B | 2008 | J Radiol2008，89，111： | 1 |
| 12 | Mother-infant relationship in galagos and the oral child transport among primates显示文摘 | Saner E | 1967 | Folia Primatol1967，7，： | 1 |
| 13 | The di-sease-free wall in coronary atherosclerosis: Its relation to degree of obstruction 显示文摘 | Saner H E Gobel F L Salomonowitz E | 1985 | J Am Coll Cardiol1985，6，5： | 1 |
| 14 | Molecular model in ab initio studies of solids and surfaces: from ionic crystal and semiconductor to catalysts显示文摘 | Saner J | 1989 | Chem Rev1989，，89： | 1 |
| 15 | Estimation of Permeability from Well Logs Using Resistivity and Saturation Data显示文摘 | Saner S Kissami M Al-Nufaili S | 1997 | SPEFE1997，12，1： | 1 |
| 16 | Hexagonally arranged monodisperse silver nanowires with adjustable diameter and high aspect ratio 显示文摘 | Choi J Saner G Nielsch K | 2003 | Chemistry of materials2003，15，： | 1 |
| 17 | MELD at POD 1 as a predictor of outcome in liver allografts with peak AST>5000U/l显示文摘 | Hoyer DP Sotiropoulos GC Saner FH | 2014 | Transpl Int2014，27，12： | 1 |
| 18 | Formation re- sistivity response to loading and unloading confining pressure 显示文摘 | Salih Saner Maclean Amabeoku Mimoune Kissami | 1996 | Journal of Petroleum Science and Engineering1996，16，： | 1 |
| 19 | Adrenocortical cell lines 显示文摘 | Rainey WE Saner K Schimmer BP | 2004 | Mol Cell Endocrinol2004，228，12： | 1 |
| 20 | Long-term cardiovascu- lar and non-cardiovascular mortality in women and men with type 1 and type 2 diabetes mellitus: a 30-year follow-up in Switzerland 显示文摘 | Allemann S Saner C Zwahlen M | 2009 | Swiss Med Wkly2009，139，3940： | 1 |
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