Journal of AdvancedMedical and Dental Sciences Research

Back Ground: The aim of this prospective study was to evaluate the incidence of postoperative bleeding after dental extraction in candidates for liver transplantation. Material & Methods: 252 liver transplanted patients were included in this study. Patients were included in the analysis when the blood examinations showed a platelet count of 30,000/mm3 or greater and an international normalized ratio (INR) of 3.0 or less. In group 1 local pressure was applied by use of gauze soaked with tranexamic acid, and in group 2 gauze without tranexamic acid was used. Absorbable hemostatic sponges and cross sutures were used as a standard hemostatic measure. Results: In the 252 patients included in this study, 148 simple extractions were performed during 105 dental surgical procedures. The main preoperative blood tests such as hematocrit level, platelet counts  and a mean INR were calculated. Postoperative bleeding occurred during only 1 procedure (2.8%), and local pressure with gauze was effective for achieving hemostasis. No statistically significant difference in the time to hemostasis was found between the 2 groups. Conclusions: This study found a low risk of bleeding for tooth extractions in patients with liver cirrhosis, INRs of 2.50 or less, and platelet counts of 30,000/mm3 or greater. Blood transfusions were not needed, and in the case of postoperative bleeding, the use of local hemostatic measures was satisfactory.
Key words: Liver transplantation, heamostasis, tranexamic acid.

Corresponding author: Dr. Atul P.S Kushwah, Senior Resident, Department of Oral and Maxillofacial Surgery, G.R. Medical College, Gwalior,  M.P., E mail: dratulkushwah@gmail.com