[Reduction of transfusion needs by the early introduction of venovenous bypass in liver transplant].
A study was made of 44 patients who underwent liver transplant, distributed into three groups: Group A: patients who had ample liver dissection before entering bypass. Group B: patients who entered bypass after dissection of the hepatic hilum and prior to any other dissection; bypass time was prolonged for meticulous hemostasia. Group C: patients with perfectly defined hemodynamic problems, not secondary to bleeding, during the anhepatic phase. Preoperatively the three groups were homogeneous as regards clinical situation. During the operation a significantly larger transfusion volume (p less than 0.01) was administered in group C during phase II (70.1 +/- 27.2 ml/kg/h), phase III (32.6 +/- 9.6 ml/kg/h) and throughout surgery (32.7 +/- 10.3 ml/kg/h) than in the other two groups. Group B received a smaller transfusion volume during phase II (14.6 +/- 8.1 ml/kg/h), phase III (12.7 +/- 5.5 ml/kg/h) and throughout surgery (11.6 +/- 4.9 ml/kg/h) than the other two groups (p less than 0.01). The transfusion needs of group A were 28.4 +/- 15.6 ml/kg/h in phase II, 26.8 +/- 17.1 ml/kg/h in phase III and 21.2 +/- 11.2 ml/kg/h throughout surgery. The duration of the anhepatic phase was significantly shorter (p less than 0.01) in group A (1 h 10' +/- 10) than in (1 h 50' +/- 10) and C (1 h 40' +/- 45'). In the postoperative period a higher mortality was associated with group C (37.5%) and a lower mortality with group B (3.33%), the mortality of group A being 16.6%. The differences were statistically significant with p less than 0.01.
Moreno González
E
E
Calleja Kempín
J
J
Pérez-Cerdá
F
F
Gómez Gutiérrez
M
M
Jover Navalón
J M
JM
Lanoa García
J I
JI
Arias Díaz
J
J
Riaño Carrera
D
D
Moral Gutiérrez
P
P
Guillén Ramírez
F
F
D000328:Adult; D001803:Blood Transfusion; D005112:Extracorporeal Circulation / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D016031:Liver Transplantation; D008875:Middle Aged; D011169:Portal Vein; D014684:Venae Cavae
Disminución de las necesidades transfusionales mediante la introducción precoz del by-pass venovenoso en el trasplante hepático.