Assessment of Progressive Changes in the Amount of Blood Transfusion of Adult Liver Transplantation / 대한마취과학회지

ABSTRACT

BACKGROUND: Liver transplantation often requires a large amount of blood products. To reduce blood bank workload and excessive blood products preparation, we evaluated the blood components use in liver transplantation. METHODS: We enrolled 300 patients who underwent liver transplantation between May 1996 to December 2003 (235 adults, 58 children, 7 retransplantations) at Samsung Medical Center, Seoul, Korea. The patients were divided into 6 groups of 50 cases per group by their operation date. We excluded children and adult patients who received retransplantation. All patient groups were retrospectively evaluated using hospital charts and computerized data. We investigated the amounts of blood components transfused during the intraoperative period. RESULTS: The amount of leukocyte-depleted red blood cells transfused showed a significant decrease when the first group (32.1+/-17.8 units) was compared to the last (5.9+/-3.2 units). Also the amount of fresh frozen plasma and leukocyte-depleted platelet concentrate transfusion showed a significant decrease but cryoprecipitate did not. When the groups were re-divided into 3 groups (liver cirrhosis, hepatocellular carcinoma, fulminant hepatitis) according to disease type, the decrease in the transfusion amounts of each disease groups were similar to the overall group. CONCLUSIONS: An improved surgical technique was verified as the most important factor with respect to decreasing the blood transfusion amount. The results of this study offfer a guideline for estimating blood product preparation requirement for liver transplantation.