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Relevance of the point-of-care device hemochron signature elite® in patients with cirrhosis during orthotopic liver transplantation

Abstract : Purpose Real-time monitoring of hemostasis is believed to facilitate clinical care during surgery in some circumstances including orthotopic liver transplantation. The aim of this study was to compare International Normalized Ratio (INR) measurement by the point-of-care device Hemochron signature Elite® (HC) with the corresponding measurements provided by a central laboratory during orthotopic liver transplantation. Methods Patients undergoing orthotopic liver transplantation were included in this observational prospective study in two tertiary hospitals (Rennes, Toulouse) in France. Central laboratory and HC measurements of INR were assessed throughout the orthotopic liver transplantation. The agreement between the INR measurement by the POC device Hemochron Signature Elite® (HC) and the corresponding measurement provided by the central laboratory during liver transplantation was measured. Results Thirty patients (143 pairs of measurements) were analyzed. The median (25th-75th percentile) INR as assessed by the central laboratory was 1.83 (1.42-2.06). The correlation coefficient between the 2 methods was 0.76 (P andlt; 0.001). The bias was 0.08 with an upper limit of agreement of +1.44 (mean +1.96 SD) and a lower limit of -1.29 (mean -1.96 SD). As INR increased, sensitivity decreased and was inferior to 50% when INR was andgt;2. Conclusion HC cannot be recommended for routine management of orthotopic liver transplantation. © 2017, American University of Beirut. All rights reserved.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01773843
Contributor : Laurent Jonchère <>
Submitted on : Monday, April 23, 2018 - 11:15:36 AM
Last modification on : Tuesday, October 20, 2020 - 10:29:12 AM

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  • HAL Id : hal-01773843, version 1

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H. Beloeil, E. Delaval, B. Bourdet, P. Gueret, S. Voisin, et al.. Relevance of the point-of-care device hemochron signature elite® in patients with cirrhosis during orthotopic liver transplantation. Middle East Journal of Anesthesiology, 2017, 24 (3), pp.181-186. ⟨hal-01773843⟩

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