The Effect of Magnesium Therapy on Thromboelastographic Findings in Patients with End Stage Liver Disease

Lee, Jaemin; Choi, Jong Ho; Chang, Hae Wone; Kim, Shi Hyeon

Abstract

BACKGROUND: Patients undergoing liver transplantation may be a group predisposed to hypomagnesemia and bleeding tendency. There is evidence that magnesium is a crucial constituent of the blood coagulation cascade and has a pro-coagulant activity. The purpose of this study was to investigate the effect of magnesium therapy on thromboelastograph (TEG) findings and other clinical parameters in patients undergoing liver transplantation.
METHODS
27 patients scheduled for liver transplantation were included. 1.5 g of magnesium sulfate was diluted in 100 ml of normal saline and infused over a period of 5 minutes to all patients. TEG findings immediately before and after magnesium infusion were compared. Total blood transfused and CaCl2 requirements in these patients were compared with those of a group of patients who received liver transplantation without magnesium therapy.
RESULTS
K time and coagulation time (r + k) showed significant reduction, and MA, A60 and TEG index showed significant increases after magnesium therapy (P < 0.05). R time reduced and alpha angle increased after magnesium therapy, but these were not statistically significant. Less blood and CaCl2 was required by these patients (P < 0.05).
CONCLUSIONS
Magnesium therapy significantly improved TEG findings of general hypocoagulability in end stage liver disease. It was also associated with a reduced amount of total blood transfused and CaCl2 required during liver transplantation.