Blood loss and transfusion requirements in liver transplantation : experience with the first 75 cases

• Published in: Anaesthesia and intensive care 1994-12, Vol.22 (6), p.666-671
• Main Authors: MCNICOL, P. L, LIU, G, HARLEY, I. D, MCCALL, P. R, PRZYBYLOWSKI, G. M, BOWKETT, J, ANGUS, P. W, HARDY, K. J, JONES, R. M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Coagulation; Blood Loss, Surgical - statistics & numerical data; Blood Substitutes - administration & dosage; Blood Transfusion - statistics & numerical data; Blood Transfusion, Autologous - statistics & numerical data; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Child; Erythrocyte Transfusion - statistics & numerical data; Female; Hemoglobins - analysis; Humans; Liver Diseases - surgery; Liver Transplantation - methods; Liver Transplantation - statistics & numerical data; Male; Medical sciences; Middle Aged; Plasma; Platelet Count; Platelet Transfusion - statistics & numerical data; Reoperation; Thrombelastography; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Victoria - epidemiology
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057x9402200604

The blood loss data and transfusion requirements including blood bank, salvaged washed red cells, fresh frozen plasma and cryoprecipitate were analysed for the first 75 cases of liver transplantation performed at the Austin Hospital between June 1988 and October 1992. The mean blood loss was 8.8 litres (standard deviation 14.1) with a median value of 4.0 litres. Blood product use expressed as mean number of units (SD) was bank red blood cells 7.1 (12.7), washed red blood cells 3.9 (5.9), fresh frozen plasma 7.1 (9.1), platelets 5.1 (7.4), and cryoprecipitate 1.7 (5.1). These results demonstrate that liver transplantation can be performed without imposing excessive demands on blood transfusion services. Management should include surgical techniques to minimize bleeding and use of autologous transfusion. Use of component therapy (FFP, platelets and cryoprecipitate) should not be empirical. It should be selective on the basis of clinical bleeding assessment and guided by results of the laboratory coagulation profile and changes in thrombelastographic (TEG) parameters.