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Physiology, Prevention, and Treatment of Blood Loss During Liver Transplantation

  • Simone F. Kleiss
  • Ton Lisman
  • Robert J. Porte
Chapter

Introduction

Historically, bleeding was one of the major challenges during liver transplantation. The first patient receiving a liver transplant in 1963 exsanguinated during the procedure [1], and massive perioperative blood loss remained a major clinical challenge until the 1980s. Most, if not all, liver transplant procedures required transfusion of blood products in those days, and transfusion requirements would often exceed 100 units of red blood cell concentrates (RBCs), with a mean transfusion requirement around 20–40 units of blood products (RBC, fresh frozen plasma, platelet concentrates, cryoprecipitate) [2, 3]. Blood products were, and still are, expensive and accounted for a significant part of the total costs of liver transplantation [4]. In the last 15–20 years, massive blood loss during liver transplantation has become rare and a significant proportion of patients can nowadays be transplanted without any requirement for blood transfusion [5, 6]. Improvements in surgical...

Keywords

Transfusion Plasma Hemostasis Bleeding Antifibrinolytics Coagulopathy 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Simone F. Kleiss
    • 1
  • Ton Lisman
    • 1
  • Robert J. Porte
    • 1
  1. 1.Section of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Department of SurgeryUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands

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