open access

Vol 48, No 1 (2016)
Review articles
Published online: 2015-04-02
Submitted: 2015-04-01
Accepted: 2015-04-01
Get Citation

Perioperative bleeding in patients undergoing liver transplantation

Małgorzata H. Starczewska, Dorota Giercuszkiewicz, Grzegorz Niewiński, Andrzej Kański
DOI: 10.5603/AIT.a2015.0020
·
Anaesthesiol Intensive Ther 2016;48(1):34-40.

open access

Vol 48, No 1 (2016)
Review articles
Published online: 2015-04-02
Submitted: 2015-04-01
Accepted: 2015-04-01

Abstract

Liver transplantation (LT) remains one of the most challenging surgical procedures. For many years uncontrolled bleeding and catastrophic haemorrhages were one of the major causes of perioperative mortality and morbidity. During the past fifty years or so, significant progress in surgical techniques and perioperative management has led to a marked change in transfusion practice over time, where up to 79.6% of LTs in experienced transplant centers are performed without any blood product transfusion. Despite this, perioperative bleeding and transfusion requirements remain potent predictors of patient’s mortality, as well as postoperative complications and graft survival. The major impact of blood product transfusion on LT recipient outcomes implies that all patients on waiting lists should be carefully screened for the presence of risk factors of perioperative bleeding. Although multiple predictors of transfusion requirements during LT have been identified, no predictive model validated across centers has been constructed. The most suitable strategies to reduce intraoperative blood loss in this group should be employed on a case-to-case basis. This paper aims to summarize the most up-to-date evidence in the management of haemostasis in LT recipients.

Abstract

Liver transplantation (LT) remains one of the most challenging surgical procedures. For many years uncontrolled bleeding and catastrophic haemorrhages were one of the major causes of perioperative mortality and morbidity. During the past fifty years or so, significant progress in surgical techniques and perioperative management has led to a marked change in transfusion practice over time, where up to 79.6% of LTs in experienced transplant centers are performed without any blood product transfusion. Despite this, perioperative bleeding and transfusion requirements remain potent predictors of patient’s mortality, as well as postoperative complications and graft survival. The major impact of blood product transfusion on LT recipient outcomes implies that all patients on waiting lists should be carefully screened for the presence of risk factors of perioperative bleeding. Although multiple predictors of transfusion requirements during LT have been identified, no predictive model validated across centers has been constructed. The most suitable strategies to reduce intraoperative blood loss in this group should be employed on a case-to-case basis. This paper aims to summarize the most up-to-date evidence in the management of haemostasis in LT recipients.

Get Citation

Keywords

liver transplantation, perioperative management, haemostasis, bleeding

About this article
Title

Perioperative bleeding in patients undergoing liver transplantation

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 48, No 1 (2016)

Pages

34-40

Published online

2015-04-02

DOI

10.5603/AIT.a2015.0020

Bibliographic record

Anaesthesiol Intensive Ther 2016;48(1):34-40.

Keywords

liver transplantation
perioperative management
haemostasis
bleeding

Authors

Małgorzata H. Starczewska
Dorota Giercuszkiewicz
Grzegorz Niewiński
Andrzej Kański

Important: This website uses cookies.tanya dokter More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

VM Media sp. z o.o. VM Group sp.k., Grupa Via Medica, Świętokrzyska 73 St., 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl