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KMID : 0870419980020020087
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
1998 Volume.2 No. 2 p.87 ~ p.91
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How Many Blood Products Should Be Prepared Prior To Adult Orthotopic Liver Transplantation
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Kim Sung-Ju
Choi Seung-Gi
Lee Sang-Min
Kim Gaab-Soo
Kim Yu-Hong
Park Yeon-Ho
Choi Seong-Ho
Sohn Tae-Sung
Cho Jae-Won
Lee Suk-Koo
Lee Byung-Boong
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Abstract
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Background: Prior to liver transplantation, anesthesiologists usually prepare huge amount of blood products , anticipating massive bleeding. But the Leukocyte depleted red blood cell (LDRBC), Leukocyte depleted Platelet concentration (LDPC), thawed fresh frozen plasma (FFP) and cryoprecipitate are discarded, if unused during the predetermined period. So , preparing optimal amount of blood products is very important. Although there is some guidelines suggested by western team about the preparation of blood products , the characteristic of liver disease is quite different between the western and eastern country. Therefore, we (esp. korean) should prepare the blood products based on our own data.
Method: Here we reviewed the amount of blood products used for adult orthotopic liver tranasplantation (hepatitis B virus origin liver cirrhosis) at our hospital (n=30) during the last 2-year period.
Result: The results are as follows: LDRBC 27.8units, FFP 46.1units, LDPC 15.7units, cryoprecipitate 3.8units. We found that the recent cases used LDRBC less (p<0.05). In addition, the age of patients was inversly correlated to the amount of LDRBC (p<0.05) When the Cell Saver reservoir was overflowed, the LDRBC usage was greately increased than the non-overflowed (p<0.05).
Conclusion: Based on the above data and the possible preparation time for various blood products at our hospital we suggest that preparing the following amount of blood products may be appropriate prior to adult orthotopic liver
transplantation in korea: LDRBC 24units, LDPC 10units and thawed FFP 30units at OR blood bank refrigerator, and cross-matched LDRBG 10units, PC 10units, unthawed FFP 20units and cryoprecipitate 12units at main blood bank refrigerator. Moreover, in preparing blood products we should consider the experience of liver transplantation team, patient’s diagnosis, patient’s age, available Cell Saver number, blood bank power.
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KEYWORD
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Liver transplantation, blood transfusion, Cell Saver
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