[An analysis on blood transfusion for hepatic resection]

Hepatic resection is prone to significant blood loss. Adverse effects of blood loss and transfusion mandate improvements in surgical techniques to reduce blood loss and transfusion.

We retrospectively analyzed the present status of intraoperative blood transfusion practice of 42 hepatic resections in National Kure Medical Center for the year of 2000.

Median values for blood loss were 1355, 1708, 1415, and 2298 ml for nonanatomic, subsegmental, segmental and extended right resections, respectively. Crossmatched to transfused blood (C/T) ratios were 1.76, 1.19, 2.31, and 0.90 for nonanatomic, subsegmental, segmental and extended right resections, respectively.

In general, C/T ratio of 1.5 to 2.5 has been recommended but own C/T ratios are 1.19 and 0.9 for subsegmental and extended right hepatic resection, which are lower than recommended values. It was estimated that inappropriate prediction of blood loss by several surgeons and unused maximum surgical blood order schedule (MSBOS) or type and screen (T&S) decreased these values of C/T ratio in the present analysis. We therefore conclude that MSBOS and T&S could be improved by avoiding such in appropriate prediction.