Transfusion practice in orthotopic liver transplantation

Area of Science:

• Transfusion Medicine
• Hepatology
• Surgical Innovation

Background:

• Liver transplantation is a complex procedure with high blood product demand.
• Despite a decade-long decline, blood use in liver transplants remains substantial.
• Recipients present unique transfusion challenges, including specialized components and immunologic effects.

Purpose of the Study:

• To review the challenges and strategies related to blood transfusion in liver transplantation.
• To highlight the importance of reducing intraoperative bleeding and transfusion requirements.
• To discuss the impact of massive transfusions on patient outcomes and costs.

Main Methods:

• Literature search conducted using Google and PubMed.
• Inclusion of related articles and standard textbooks on Transfusion Medicine.
• Synthesis of current knowledge on blood loss and transfusion in liver transplant procedures.

Main Results:

• Intraoperative blood loss in liver transplantation is multifactorial, stemming from technical aspects and coagulation issues.
• Massive blood loss and transfusions are linked to increased postoperative infections, graft dysfunction, multi-organ failure, and mortality.
• Significant reduction in blood use has been observed over the past decade.

Conclusions:

• Minimizing intraoperative bleeding is essential for improving liver transplant outcomes.
• Limiting blood transfusions can enhance graft survival, reduce complications, and control healthcare costs.
• Further efforts are needed to optimize transfusion strategies and patient management in liver transplantation.