Context:Extensive bleeding associated with liver transplantation is a major challenge faced by transplant surgeons, worldwide.Aims:To evaluate the blood component consumption and determine preoperative factors that predict the same in living donor liver transplantation (LDLT).Settings and Design:This prospective study was performed for a 1 year period, from March 2010 to February 2011.Materials and Methods:Intra- and postoperative utilization of blood components in 152 patients undergoing LDLT was evaluated and preoperative patient parameters like age, gender, height, weight, disease etiology, hemoglobin (Hb), hematocrit (Hct), platelet count (Plt), total leukocyte count (TLC), activated partial thromboplastin time (aPTT), international normalized ratio (INR), serum bilirubin (T. bilirubin), total proteins (T. proteins), albumin to globulin ratio (A/G ratio), serum creatinine (S. creatinine), blood urea (B. urea), and serum electrolytes were assessed to determine their predictive values. Univariate and stepwise discriminant analysis identified those factors, which could predict the consumption of each blood component.Results:The average utilization of packed red cells (PRCs), cryoprecipitates (cryo), apheresis platelets, and fresh frozen plasma was 8.48 units, 2.19 units, 0.93 units, and 2,025 ml, respectively. Disease etiology and blood component consumption were significantly correlated. Separate prediction models which could predict consumption of each blood component in intra and postoperative phase of LDLT were derived from among the preoperative Hb, Hct, model for end-stage liver disease (MELD) score, body surface area (BSA), Plt, T. proteins, S. creatinine, B. urea, INR, and serum sodium and chloride.Conclusions:Preoperative variables can effectively predict the blood component requirements during liver transplantation, thereby allowing blood transfusion services in being better prepared for surgical procedure.

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Introduction and aims: Liver transplant surgery is often associated with considerable bleeding. This study was undertaken to analyse the average blood component consumption and the effectiveness of preoperative laboratory assessment and Model For End Stage Liver Disease (MELD) score in the estimation of transfusion requirements in Living Donor Liver Transplantation (LDLT).Material and methods: Univariate and stepwise regression analysis were employed to establish the significance of correlation of the preoperative laboratory variables, including haematocrit, platelet count, INR, total bilirubin, serum creatinine, blood urea and MELD score with the total consumption of Packed Red Cells (PRCs), cryoprecipitates, aphaeresis platelets and Fresh Frozen Plasma (FFP). Stepwise discriminant analysis was used to identify those preoperative factors which have a significant predictive value for the total consumption of each blood component and these results were employed to construct separate prediction models for the utilization of each blood component and the respective R square values were determined.Results: A total of 509 patients were included. On an average, 8.44 units (SD ¼ 6.11) of PRCs, 2.58 units (SD ¼ 2.95) of cryoprecipitates, 0.81 units (SD ¼ 1.16) of aphaeresis platelets and 2074.85 ml (SD ¼ 1240.20) of FFP were consumed per LDLT. The blood component prediction models could be employed to accurately predict the total utilisation of PRCs, cryoprecipitates, FFP and aphaeresis platelets in 23, 22.6, 17.8 and 20.7 per cent of our patients, respectively. Conclusion:We have been able to identify those preoperative factors which can be employed to predict the consumption of various blood components in living donor liver graft recipients. These variables were further employed to construct prediction models,

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