Changing trends in transfusion practice in liver transplantation.
OBJECTIVE
Prevention of excessive blood loss is an important issue in the perioperative management of liver transplantation. This review describes changing trends in blood products use, risk predicting of blood transfusion, variability in use and practices, as well as transfusion safety during liver transplantation.


RESULTS
Over the last 20 years, the average use of blood products per case has considerably decreased. There are marked interinstitutional differences in blood use. Differences in patient population characteristics and surgical techniques are a partial explanation, but differences in transfusion practices probably account for a substantial part of the variability. Recent data have sparked off ongoing controversy relating to volume replacement therapy and its impact on blood loss. New studies emphasize the risks associated with transfusion in liver transplantation.


CONCLUSIONS
Recent studies call for continuing every reasonable effort to minimize the use of blood components and can guide us in new approaches to this vital problem.
Ozier
Yves
Y
Head of the Anesthesia and Critical Care Department, Hopital Cochin, Paris, France. yves.ozier@cch.aphp.fr
Tsou
Mei-Yung
MY
D001803:Blood Transfusion / Q000639:trends*; D006801:Humans; D016031:Liver Transplantation / Q000639:trends*; D019990:Perioperative Care / Q000639:trends*; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D065227:Transfusion Reaction