Liver transplantation and risk of bleeding.

Abstract:

PURPOSE OF REVIEW:Blood loss in orthotopic liver transplantation has declined during the past decade. Recent papers addressed this issue and emphasized its importance, because there is a significant correlation between intraoperative blood transfusion requirements and postoperative morbidity. This review addresses changes in practice that might have led to reduced blood loss. RECENT FINDINGS:Many preoperative variables that predict blood loss during orthotopic liver transplantation have been found. These vary between studies. Differences in perioperative blood loss, transfusion criteria and intraoperative management of coagulation may account for the interhospital variations in transfusion of red blood cells during orthotopic liver transplantation. Therefore, a risk index developed in one centre should not be applied without evaluation in other centres. Introduction of the piggyback technique and close monitoring of coagulation with thromboelastography have led to reduced blood transfusion requirements. Use of antifibrinolytics has shown to decrease blood loss. Recombinant factor VIIa is not indicated for treatment of coagulation abnormalities during orthotopic liver transplantation, and its use is justified only as rescue therapy. SUMMARY:Recent changes in blood conservation practices in orthotopic liver transplantation are presented and discussed.

authors

Groenland TH,Porte RJ,Metselaar HJ

doi

10.1097/MOT.0b013e32814e6bb0

subject

Has Abstract

pub_date

2007-06-01 00:00:00

pages

287-293

issue

3

eissn

1087-2418

issn

1531-7013

pii

00075200-200706000-00016

journal_volume

12

pub_type

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