Response to Comment on: Early recovery pathway for hepatectomy: data-driven liver resection care and recovery.

We are grateful for the questions raised by Drs. Blasi and Beltran and appreciate the opportunity to respond (1). The comment on our article entitled Early recovery pathway for hepatectomy: data-driven liver resection care and recovery questions the recommendation that fresh frozen plasma (FFP) transfusion be used to correct coagulopathy based on international normalized ratio (INR) and clinical risk factors for coagulopathy in patients following liver resection (1,2).

[1]  A. Blasi,et al.  Comment on: Early recovery pathway for hepatectomy: data-driven liver resection care and recovery. , 2018, Hepatobiliary surgery and nutrition.

[2]  Y. Fong,et al.  Early recovery pathway for hepatectomy: data-driven liver resection care and recovery. , 2017, Hepatobiliary surgery and nutrition.

[3]  D. Bramley,et al.  Viscoelastic testing for hepatic surgery: a systematic review with meta-analysis—a protocol , 2016, Systematic Reviews.

[4]  R. Risco,et al.  Prophylactic Use of Fresh Frozen Plasma in Patients Undergoing Liver Resection: Does it Make any Sense? , 2014 .

[5]  A. Sauaia,et al.  Initial experiences with point‐of‐care rapid thrombelastography for management of life‐threatening postinjury coagulopathy , 2012, Transfusion.

[6]  C. Wade,et al.  Rapid thrombelastography delivers real-time results that predict transfusion within 1 hour of admission. , 2011, The Journal of trauma.

[7]  L. Auler,et al.  Perioperative coagulation profile in living liver donors as assessed by rotational thromboelastometry , 2010, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[8]  E. Moore,et al.  Noncitrated whole blood is optimal for evaluation of postinjury coagulopathy with point-of-care rapid thrombelastography. , 2009, The Journal of surgical research.

[9]  J. Segal,et al.  Paucity of studies to support that abnormal coagulation test results predict bleeding in the setting of invasive procedures: an evidence‐based review , 2005, Transfusion.

[10]  R. Frumento,et al.  Thromboelastography Maximum Amplitude Predicts Postoperative Thrombotic Complications Including Myocardial Infarction , 2005, Anesthesia and analgesia.

[11]  M. Rizzetto,et al.  Thromboelastogram monitoring in the perioperative period of hepatectomy for adult living liver donation , 2004, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[12]  Robert C. G. Martin,et al.  The use of fresh frozen plasma after major hepatic resection for colorectal metastasis: is there a standard for transfusion? , 2003, Journal of the American College of Surgeons.

[13]  J. Vauthey,et al.  Venous Thromboembolism Prophylaxis in Liver Surgery , 2015, Journal of Gastrointestinal Surgery.