TY - JOUR
T1 - Liver transplantation and risk of bleeding
AU - Groenland, Theo H.N.
AU - Porte, Robert J.
AU - Metselaar, Herold J.
N1 - © 2007 Lippincott Williams & Wilkins
PY - 2007/6
Y1 - 2007/6
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=34249091715&partnerID=8YFLogxK
UR - https://www.researchgate.net/publication/232177285_Liver_transplantation_and_risk_of_bleeding
U2 - 10.1097/MOT.0b013e32814e6bb0
DO - 10.1097/MOT.0b013e32814e6bb0
M3 - Review article
C2 - 27711020
AN - SCOPUS:34249091715
SN - 1087-2418
VL - 12
SP - 287
EP - 293
JO - Current Opinion in Organ Transplantation
JF - Current Opinion in Organ Transplantation
IS - 3
ER -