Efficacy of intraoperative blood salvage and autotransfusion in living-donor liver transplantation: a retrospective cohort study

• Published in: Korean journal of anesthesiology 2024, 77(3), , pp.345-352
• Main Authors: Lee, Jongchan, Park, Sujung, Lee, Jae Geun, Choo, Sungji, Koo, Bon-Nyeo
• Format: Article
• Language: English
• Subjects: Adult; autologous blood transfusion; autotransfusion; blood coagulation; Blood Loss, Surgical - prevention & control; blood transfusion; Blood Transfusion, Autologous - methods; Clinical; Cohort Studies; Erythrocyte Transfusion - methods; Female; Humans; liver transplantation; Liver Transplantation - methods; Living Donors; Male; Middle Aged; operative blood salvage; Operative Blood Salvage - methods; postoperative complications; Retrospective Studies; Treatment Outcome; 마취과학
• ISSN: 2005-6419; 2005-7563
• DOI: 10.4097/kja.23599

Liver transplantation (LT) may be associated with massive blood loss and the need for allogeneic blood transfusion. Intraoperative blood salvage autotransfusion (IBSA) can reduce the need for allogeneic blood transfusion. This study aimed to investigate the effectiveness of blood salvage in LT. Among 355 adult patients who underwent elective living-donor LT between January 1, 2019, and December 31, 2022, 59 recipients without advanced hepatocellular carcinoma received IBSA using Cell Saver (CS group). Based on sex, age, model for end-stage liver disease (MELD) score, preoperative laboratory results, and other factors, 118 of the 296 recipients who did not undergo IBSA were matched using propensity score (non-CS group). The primary outcome was the amount of intraoperative allogenic red blood cell (RBC) transfusion. Comparisons were made between the two groups regarding the amount of other blood components transfused and postoperative laboratory findings. The transfused allogeneic RBC for the CS group was significantly lower than that of the non-CS group (1,506.0 vs. 1,957.5 ml, P = 0.026). No significant differences in the transfused total fresh frozen plasma, platelets, cryoprecipitate, and estimated blood loss were observed between the two groups. The postoperative allogeneic RBC transfusion was significantly lower in the CS group than in the non-CS group (1,500.0 vs. 2,100.0 ml, P = 0.039). No significant differences in postoperative laboratory findings were observed at postoperative day 1 and discharge. Using IBSA during LT can effectively reduce the need for perioperative allogeneic blood transfusions without causing subsequent coagulopathy.