Viscoelastic Testing for the Laboratorian: Recent Advances and Practical Advice.

Viscoelastic testing is increasingly recognized as a standard-of-care tool for goal-directed transfusion management, with expanding endorsement from national and international guidelines. Its clinical utility is well established across several high-acuity settings, including cardiothoracic surgery, trauma, liver transplantation, and obstetric hemorrhage. These next-generation systems use alternative detection technologies and generate distinct numerical outputs for comparable TEG 5000 and ROTEM delta parameters, making institution-specific validation of transfusion thresholds essential. This article provides an overview of recent advances in viscoelastic testing and offers practical guidance for laboratorians involved in incorporating these emerging technologies into clinical workflows.