{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:08:19Z","timestamp":1774260499332,"version":"3.50.1"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There is increasing evidence that portal hypertension plays a major role in bleeding risk during orthotopic liver transplantation (OLT). We investigated the association between preoperative blood levels of von Willebrand factor (VWF) and soluble CD163 (sCD163), which are established markers of portal hypertension, and blood loss and transfusion requirements during OLT. We measured levels of VWF and sCD163 in preoperative serum samples of 168 adult patients undergoing a primary OLT between 1998 and 2012. Preoperative levels of VWF and sCD163 correlated with the model of end-stage liver disease (MELD) score (r\u2009=\u20090.414, p\u2009&lt;\u20090.001 and r\u2009=\u20090.382, p\u2009&lt;\u20090.001, respectively). Patients with high VWF or sCD163 levels (VWF and sCD163 levels above the median) had a substantially increased risk of needing red blood cell transfusion compared with patients with low VWF or sCD163 levels (VWF and sCD163 levels below the median) (odds ratio 3.5 [95% confidence interval, CI 1.7\u20137.0] and 2.3 [95% CI 1.1\u20134.5], respectively). Blood loss was highest in patients with both high VWF or sCD163 levels and a high preoperative international normalized ratio. Elevated blood levels of markers of portal hypertension are associated with increased blood loss and transfusion requirements during OLT and support the notion that portal hypertension is an important contributor to perioperative blood loss.<\/jats:p>","DOI":"10.1055\/s-0040-1714202","type":"journal-article","created":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T23:06:07Z","timestamp":1596668767000},"page":"751-756","source":"Crossref","is-referenced-by-count":7,"title":["Blood Markers of Portal Hypertension Are Associated with Blood Loss and Transfusion Requirements during Orthotopic Liver Transplantation"],"prefix":"10.1055","volume":"46","author":[{"given":"Freeha","family":"Arshad","sequence":"additional","affiliation":[{"name":"Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ton","family":"Lisman","sequence":"additional","affiliation":[{"name":"Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"},{"name":"Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Porte","sequence":"additional","affiliation":[{"name":"Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,8,5]]},"reference":[{"key":"ref1","first-page":"169","volume-title":"Physiology, prevention and treatment of blood loss during orthotopic liver transplantation","author":"F Arshad","year":"2012"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1159\/000088056","article-title":"Minimizing blood loss in liver transplantation: progress through research and evolution of techniques","volume":"22","author":"M T de Boer","year":"2005","journal-title":"Dig Surg"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1213\/01.ane.0000289638.26666.ed","article-title":"The impact of intraoperative transfusion of platelets and red blood cells on survival after liver transplantation","volume":"106","author":"M T de Boer","year":"2008","journal-title":"Anesth Analg"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1007\/BF03027720","article-title":"Survival rate changes with transfusion of blood products during liver transplantation","volume":"52","author":"L Massicotte","year":"2005","journal-title":"Can J Anaesth"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1177\/108925320400800402","article-title":"Transfusion of blood products affects outcome in cardiac surgery","volume":"8","author":"B D Spiess","year":"2004","journal-title":"Semin Cardiothorac Vasc Anesth"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1213\/ane.0b013e3181948a59","article-title":"Platelet transfusion during liver transplantation is associated with increased postoperative mortality due to acute lung injury","volume":"108","author":"I T Pereboom","year":"2009","journal-title":"Anesth Analg"},{"issue":"09","key":"ref7","first-page":"888","article-title":"Intraoperative changes in blood coagulation and thrombelastographic monitoring in liver transplantation","volume":"64","author":"Y G Kang","year":"1985","journal-title":"Anesth Analg"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1097\/00007890-198906000-00012","article-title":"Systemic effects of tissue plasminogen activator-associated fibrinolysis and its relation to thrombin generation in orthotopic liver transplantation","volume":"47","author":"R J Porte","year":"1989","journal-title":"Transplantation"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1002\/hep.1840090509","article-title":"Liver transplantation: intraoperative changes in coagulation factors in 100 first transplants","volume":"9","author":"J H Lewis","year":"1989","journal-title":"Hepatology"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.cld.2008.09.004","article-title":"Heparin-like effect in liver disease and liver transplantation","volume":"13","author":"M Senzolo","year":"2009","journal-title":"Clin Liver Dis"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.jhep.2009.12.001","article-title":"Normal to increased thrombin generation in patients undergoing liver transplantation despite prolonged conventional coagulation tests","volume":"52","author":"T Lisman","year":"2010","journal-title":"J Hepatol"},{"issue":"07","key":"ref12","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1097\/TP.0b013e318168fcd4","article-title":"Coagulation defects do not predict blood product requirements during liver transplantation","volume":"85","author":"L Massicotte","year":"2008","journal-title":"Transplantation"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1002\/hep.20569","article-title":"Evidence of normal thrombin generation in cirrhosis despite abnormal conventional coagulation tests","volume":"41","author":"A Tripodi","year":"2005","journal-title":"Hepatology"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1097\/TP.0000000000000253","article-title":"Relationship between conventional coagulation tests and bleeding for 600 consecutive liver transplantations","volume":"98","author":"L Massicotte","year":"2014","journal-title":"Transplantation"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.cld.2008.09.012","article-title":"Bleeding in liver surgery: prevention and treatment","volume":"13","author":"E M Alkozai","year":"2009","journal-title":"Clin Liver Dis"},{"issue":"08","key":"ref16","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1007\/s00268-010-0544-y","article-title":"Effects of low central venous pressure during preanhepatic phase on blood loss and liver and renal function in liver transplantation","volume":"34","author":"Z Y Feng","year":"2010","journal-title":"World J Surg"},{"issue":"09","key":"ref17","doi-asserted-by":"crossref","first-page":"3087","DOI":"10.1016\/j.transproceed.2014.10.005","article-title":"Predicting fluid responsiveness in patients undergoing orthotopic liver transplantation: effects on intraoperative blood transfusion and postoperative complications","volume":"46","author":"N Lekerika","year":"2014","journal-title":"Transplant Proc"},{"issue":"12","key":"ref18","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1097\/TP.0b013e318250fc25","article-title":"Transfusion rate for 500 consecutive liver transplantations: experience of one liver transplantation center","volume":"93","author":"L Massicotte","year":"2012","journal-title":"Transplantation"},{"issue":"02","key":"ref19","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/j.1365-2036.2012.05134.x","article-title":"Soluble CD163, a marker of Kupffer cell activation, is related to portal hypertension in patients with liver cirrhosis","volume":"36","author":"H Gr\u00f8nbaek","year":"2012","journal-title":"Aliment Pharmacol Ther"},{"issue":"04","key":"ref20","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1002\/hep.25806","article-title":"von Willebrand factor as new noninvasive predictor of portal hypertension, decompensation and mortality in patients with liver cirrhosis","volume":"56","author":"M Ferlitsch","year":"2012","journal-title":"Hepatology"},{"issue":"08","key":"ref21","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1136\/gut.2010.235689","article-title":"Von Willebrand factor levels predict clinical outcome in patients with cirrhosis and portal hypertension","volume":"60","author":"V La Mura","year":"2011","journal-title":"Gut"},{"issue":"09","key":"ref22","first-page":"2061","article-title":"Methodological issues with coagulation testing in patients with liver disease","volume":"4","author":"T Lisman","year":"2006","journal-title":"J Thromb Haemost"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/s12871-019-0767-x","article-title":"Safety of coagulation factor concentrates guided by ROTEM\u2122-analyses in liver transplantation: results from 372 procedures","volume":"19","author":"M Hartmann","year":"2019","journal-title":"BMC Anesthesiol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1177\/000456329202900110","article-title":"Plasma and serum von Willebrand factor antigen concentrations in connective tissue disorders","volume":"29","author":"A D Blann","year":"1992","journal-title":"Ann Clin Biochem"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1093\/ajcp\/104.3.264","article-title":"Laboratory assessment of von Willebrand factor. Use of different assays can influence the diagnosis of von Willebrand's disease, dependent on differing sensitivity to sample preparation and differential recognition of high molecular weight VWF forms","volume":"104","author":"E J Favaloro","year":"1995","journal-title":"Am J Clin Pathol"}],"container-title":["Seminars in Thrombosis and Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1714202.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T22:40:29Z","timestamp":1599691229000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1714202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,5]]},"references-count":25,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2020,9,9]]},"published-print":{"date-parts":[[2020,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1714202","relation":{},"ISSN":["0094-6176","1098-9064"],"issn-type":[{"value":"0094-6176","type":"print"},{"value":"1098-9064","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,5]]}}}