Long-term postoperative bleeding after dentoalveolar surgery in the pretransplant liver failure patient

Abstracts on this page have been chosen and edited by Dr Trevor Watts

Abstract

Some patients required hospital admission for control of postoperative haemorrhage.

Main

Ward BB, Weideman EM. J Oral Maxillofac Surg 2006; 64: 1469–1474

The liver produces 11 of the 13 coagulation factors, and stores vitamin K. Dysfunction can affect these processes and also lead to reduction of platelets. In this study, 30 patients awaiting liver transplants had 35 minor oral surgical procedures and were given local haemostatic attention before discharge and follow-up. Patients were categorised by the surgeon prior to surgery as having a minimal, moderate or high risk of bleeding, and pre-operative platelet and INR tests helped determine management.

The minimal risk patients had 17 procedures, 8 received prior platelet transfusions (PT) and 1 received fresh frozen plasma. In the moderate risk group of 8 patients, 2 had PT and 1 was admitted for management. In the high risk group of 10 patients, 4 had PT, and 4 of 5 experiencing long term bleeding were admitted (average stay was 4 days). The authors comment that patients requiring 10 or more simple extractions have a high risk of bleeding problems.