Preoperative factors as predictors of blood product transfusion requirements in orthotopic liver transplantation

Abstract

Mean blood loss was 54.2 (SD, 47.9) mL/kg, the mean (SD) for amounts of blood products transfused was 25.3 (19.5) mL/kg for packed red blood cells, 2.6 (3.3) units for fresh frozen plasma, and 1.7 (3.1) units for platelets. Seven recipients (2.7%) underwent transplantation without intraoperative transfusion of red blood cells, whereas 25 patients (9.6%) received more than 10 units of red blood cells intraoperatively. Multivariable analysis showed that no preoperative factor was a predictor of blood loss or requirement for intraoperative transfusion. Transfusion of fresh frozen plasma and packed red blood cells was significantly lower in 2005, 2006, 2007, and 2008 than in 2003 to 2004 (P < .001).

Hemostatic status in liver transplantation: Association between preoperative procoagulants/anticoagulants and postoperative hemorrhaging/thrombosis

“…Traditionally, liver transplant recipients are considered to be in a hypocoagulable state, as evidenced by abnormalities in routine hemostatic tests such as the PT and platelet count and massive perioperative transfusion requirements . This conflicts, however, with the trend of transfusion‐free liver transplant procedures and the finding that prolonged PT and APTT or thrombocytopenia does not correlate with the amount of intraoperative blood loss . With the emergence of the concept of rebalanced hemostasis, there is an increasing awareness of perioperative thrombotic complications.…”

“…Similar findings were also reported from a high‐volume Korean LDLT center and for deceased donor liver transplantation . This tendency was also confirmed in our study, but in contrast to our results, previous studies found no possible association between preoperative coagulopathy and postoperative hemorrhaging . Our results clearly demonstrated that the more severe the liver disease was, the higher the incidence of hemorrhagic complications was.…”

A quantitative model to predict blood use in adult orthotopic liver transplantation

“…Higher cMELD scores may indicate worse residual liver functions, and could be associated with susceptibility to coagulopathy. However, conflicting results have been reported regarding the association between cMELD score and blood transfusion in OLT [41,42,[44][45][46][47][48][49][50]. It was not always specified in these studies whether cMELD score was separated from its components for the multivariate analysis.…”

A data‐driven patient blood management strategy in liver transplantation

“…>1 blood volume in 24 h) . Towards the turn of the century, significantly lower utilization rates were reported, but there was still significant interinstitutional variation and apparently large standard deviation within institutions . Given this variation, different programmes need varying standard amounts of blood products available prior to a liver transplant that can result in ineffective utilization of a vital resource.…”