Hypocoagulability,Hypercoagulability and the Interpretation of ‘Normal’ Kaolin-Activated Thrombelastographs in the Perioperative Period

Kaolin-activated whole blood thrombelastography (TEG) is an appealing test of coagulation in the perioperative period, because it assesses many aspects of coagulation and can be performed at the point of care. In this issue, Weinberg et al report the use of kaolin-activated TEG as a global assessment of coagulation as part of their investigation of coagulation activation after hepatic resection for cancer¹. However, while kaolin-activated TEG assesses many aspects of coagulation, it does not assess all aspects of coagulation, so ‘normal’ findings should be interpreted with caution.