Blood loss in orthotopic liver transplantation: a retrospective analysis of transfusion requirements and the effects of autotransfusion of cell saver blood in 164 consecutive patients

2000 ◽  
Vol 11 ◽  
pp. S87-S93 ◽  
Author(s):  
H. G. D. Hendriks ◽  
J. van der Meer ◽  
I. J. Klompmaker ◽  
N. Choudhury ◽  
J. A. M. Hagenaars ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Blood Loss ◽  
Retrospective Analysis ◽  
Orthotopic Liver Transplantation ◽  
Cell Saver ◽  
Transfusion Requirements

scholarly journals Impact of blood salvage during liver transplantation on reduction in transfusion requirements

2006 ◽  
Vol 21 (suppl 1) ◽  
pp. 44-47 ◽  
Author(s):  
Ajith Kumar Sankarankutty ◽  
Andreza Correa Teixeira ◽  
Fernanda Fernandes Souza ◽  
Enio David Mente ◽  
Gustavo Ribeiro de Oliveira ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Blood Loss ◽  
Cell Saver ◽  
Cell Salvage ◽  
Intraoperative Blood Loss ◽  
Packed Red Blood Cells ◽  
Blood Salvage ◽  
Transfusion Requirements ◽  
Cadaveric Donors ◽  
Median Blood Loss

PURPOSE: The aim of this study was to analyse the changes in transfusion requirements, in patients submitted to orthotopic liver transpantation from cadaveric donors, with the use of intraoperative red blood cell salvage (Cell Saver). METHODS: Data from 41 transplants were analysed. Intraoperative blood loss was calculated from the cell salvage, suction and the swabs. The autologous and heterologous transfusions were recorded The red blood salvage was performed using the Cell Saver 5 System (Haemonetics).. For analysis the patients were divided in two groups: one that used the Cell Saver and another that didn't. RESULTS: The median age of the patients was 50 years and the main indication for liver transplantation was cirrhosis (35 cases - 85.3%). The median blood loss was 8362 + 3994 ml (with the Cell Saver) and 10824 + 7002 ml (without the Cell Saver) and the median transfusion of heterologous packed red blood cells was 9,6 + 8 units (with the Cell Saver) compared to 22,3 + 21 units (without the Cell Saver). CONCLUSIONS: The Cells Saver has the potential to reduce the need for heterologous blood transfusion reducing the risks of transmissible diseases.

scholarly journals Blood Markers of Portal Hypertension Are Associated with Blood Loss and Transfusion Requirements during Orthotopic Liver Transplantation

2020 ◽  
Vol 46 (06) ◽  
pp. 751-756 ◽  
Author(s):  
Freeha Arshad ◽  
Ton Lisman ◽  
Robert J. Porte
Keyword(s):  
Liver Transplantation ◽  
Portal Hypertension ◽  
Blood Loss ◽  
Orthotopic Liver Transplantation ◽  
Red Blood Cell Transfusion ◽  
Blood Levels ◽  
Serum Samples ◽  
Preoperative Serum ◽  
Transfusion Requirements ◽  
Increased Risk

AbstractThere is increasing evidence that portal hypertension plays a major role in bleeding risk during orthotopic liver transplantation (OLT). We investigated the association between preoperative blood levels of von Willebrand factor (VWF) and soluble CD163 (sCD163), which are established markers of portal hypertension, and blood loss and transfusion requirements during OLT. We measured levels of VWF and sCD163 in preoperative serum samples of 168 adult patients undergoing a primary OLT between 1998 and 2012. Preoperative levels of VWF and sCD163 correlated with the model of end-stage liver disease (MELD) score (r = 0.414, p < 0.001 and r = 0.382, p < 0.001, respectively). Patients with high VWF or sCD163 levels (VWF and sCD163 levels above the median) had a substantially increased risk of needing red blood cell transfusion compared with patients with low VWF or sCD163 levels (VWF and sCD163 levels below the median) (odds ratio 3.5 [95% confidence interval, CI 1.7–7.0] and 2.3 [95% CI 1.1–4.5], respectively). Blood loss was highest in patients with both high VWF or sCD163 levels and a high preoperative international normalized ratio. Elevated blood levels of markers of portal hypertension are associated with increased blood loss and transfusion requirements during OLT and support the notion that portal hypertension is an important contributor to perioperative blood loss.

Tranexamic Acid Reduces Blood Loss, Transfusion Requirements, and Coagulation Factor Use in Primary Orthotopic Liver Transplantation

1996 ◽  
Vol 85 (5) ◽  
pp. 1043-1048 ◽  
Author(s):  
John F. Boylan ◽  
John R. Klinck ◽  
Alan N. Sandler ◽  
Ramiro Arellano ◽  
Paul D. Greig ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Orthotopic Liver Transplantation ◽  
Interquartile Range ◽  
High Dose ◽  
Intraoperative Blood Loss ◽  
End Stage ◽  
Donor Exposure

Background Patients with end-stage liver disease frequently incur large-volume blood loss during liver transplantation associated with mechanical factors, preexisting coagulopathy, and intraoperative fibrinolysis. Methods Between April 1992 and May 1994, the authors of this double-blind, randomized, placebo-controlled study examined the effect of high-dose tranexamic acid (maximum of 20 g) on blood loss and blood product requirements in patients undergoing primary isolated orthotopic liver transplantation. Primary outcome measures were volume of blood loss (intraoperative blood loss and postoperative drainage) and erythrocyte, plasma, platelet, and cryoprecipitate use during surgery and the first 24 h of intensive care unit stay. Results Patients receiving tranexamic acid (n = 25) had less intraoperative blood loss (median, 4.3 l; interquartile range, 2.5 to 7.9; P = 0.006) compared with the placebo group (n = 20; median, 8 l; interquartile range, 5 to 15.8), and reduced intraoperative plasma, platelet, and cryoprecipitate requirements. Median perioperative erythrocyte use was 9 units (interquantile range, 4 to 14 units) in patients receiving tranexamic acid and 13 units (interquantile range, 7.5 to 31 units) in controls (P = 0.03). Total perioperative donor exposure was 20.5 units (interquantile range, 16 to 41 units) in patients receiving tranexamic acid and 43.5 units (interquantile range, 29.5 to 79 units) in controls (P = 0.003). Results for postoperative wound drainage were similar. Hospital stay and need for retransplantation were comparable in both groups. No patient in either group showed clinical evidence of hepatic artery or portal venous thrombosis within 1 month of transplantation. Conclusions High-dose tranexamic acid significantly reduces intraoperative blood loss and perioperative donor exposure in patients with end-stage parenchymal liver disease who are undergoing orthotopic liver transplantation, with marked reductions in platelet and cryoprecipitate requirements.

Liver Transplant

2013 ◽  
Author(s):  
Ximena Soler ◽  
Lori A Aronson ◽  
Gillian Derrick
Keyword(s):  
Liver Transplantation ◽  
Blood Loss ◽  
Liver Failure ◽  
Liver Transplant ◽  
Orthotopic Liver Transplantation ◽  
Massive Hemorrhage ◽  
Blood Products ◽  
End Stage

Liver transplantation is an established therapy in pediatric end-stage liver failure. Blood loss during orthotopic liver transplantation (OLT) is highly variable. Massive hemorrhage and transfusion of blood products, with its related consequences, is a well-known complication of this operation.

Preoperative variables associated with transfusion requirements in orthotopic liver transplantation

2014 ◽  
Vol 50 (1) ◽  
pp. 99-105 ◽  
Author(s):  
Gil Cunha De Santis ◽  
Denise Menezes Brunetta ◽  
Mirella Nardo ◽  
Luciana Correa Oliveira ◽  
Fernanda Fernandes Souza ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Transfusion Requirements
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