Identification of Preoperative Predictors of Intraoperative Blood Transfusion Requirements in Living Donor Liver Transplantation-Analysis of 772 Cases at a Single Center

Abstract

Living-donor liver transplantation (LDLT) is now an important option for the treatment of patients with end-stage or irreversible liver disease. We have previously reported the quantities of blood required for transplantation in 772 cases of LDLT performed from June 1990 to March 2002 at Kyoto University Hospital. In the present study we retrospectively analyzed the preoperative factors associated with massive blood losses during LDLT. The patients were divided into two groups, with the upper quartile was defined as the high blood loss (HBL) group and the lower three quartiles as the low blood loss (LBL) group. Preoperative variables between the groups were compared and statistically analyzed by chi-square analysis or the Mann-Whitney U-test. Results showed that predictors of HBL were age ( 2.0g/dl), T-Bil (>10.0g/dl), D-Bil (>10.0g/dl), Cre (>1.0g/dl) and BUN (>30.0g/dl); pre-operative hospitalization; re-transplantation; and diagnosis (Biliary atresia, Budd-Chiari syndrome). In conclusion, particular care against the possibility of massive intra-operative blood loss should be taken in patients with low age, anemia, severe liver dysfunction, and renal dysfunction.