Pediatric liver transplantation without red blood cell transfusion

The authors report the first case of orthotopic liver transplantation in a pediatric patient in whom packed red blood cell transfusion was not required. This has obvious advantages in avoiding the infectious complications of transfusion. Our patient required 3 U of fresh frozen plasma for treatment of preexisting coagulopathy. However, it is possible that, with future advances in transfusion therapy, synthetic coagulation factors may be provided in which there is no risk of infectious complications, and therefore a truly "bloodless" orthotopic liver transplant can be performed.