[Problems of blood replacement in liver transplantation]

Liver transplantation often is accompanied with massive bleeding-blood losses up to 125 I have been reported. A survey of 21 transplantations describes the management for substitution of blood components. After an initial series of 18 patients including 4 cases with blood losses exceeding 100 units of blood, an attempt was made to optimize coagulation in 5 cases with NT-values below 40% by preoperative plasmapheresis. Platelet transfusion was performed in all cases with platelet values below 120 000. These measures led to a significant reduction in blood units substituted during the last 9 transplantations.