title: Efficacy of cell saver use in living-donor liver transplant.
abstract: OBJECTIVE
  Liver transplant currently is the best treatment option for end-stage liver disease. During liver transplant, there is major blood loss due to surgery and primary disease. By using a cell saver, the need for blood transfusion is markedly reduced. In this study, we aimed to evaluate the efficacy of cell saver use on morbidity and mortality in living-donor liver transplant.
  
  
  METHODS
  We retrospectively evaluated 178 living-donor liver transplants, performed from 2005 to 2013 in our center. Child-Turcotte-Pugh A patients, deceased-donor liver transplants, and liver transplants performed for fulminant hepatic failure were not included in this study. Intraoperative blood transfusion was done in all patients to keep hemoglobin level between 10 and 12 g/dL. Cell saver was used in all liver transplants except in patients with malignancy, hepatitis B, and hepatitis C.
  
  
  RESULTS
  We included 126 patients in the study. Cell saver was used in 84 liver transplants (66%). In 42 patients (34%), liver transplant was performed without a cell saver. In living-donor liver transplant with cell saver use, 10 mL/kg blood (range, 2-50 mL/kg blood) was transfused from the cell saver; in addition, 5 to 10 mL/kg allogeneic blood was transfused. In living-donor liver transplant without cell saver, 20 to 25 mL/kg allogeneic blood was transfused.
  
  
  CONCLUSIONS
  During liver transplant, major blood transfusion is needed because of surgery and primary disease. Cell saver use markedly decreases the need for allogeneic blood transfusion and avoids adverse events of massive transfusion.
authors.affiliation: From the Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Mahir
authors.initials: M
authors.lastname: Kırnap
authors.forename: Tugan
authors.initials: T
authors.lastname: Tezcaner
authors.forename: Hatice Ebru
authors.initials: HE
authors.lastname: Ayvazoğlu Soy
authors.forename: Aydıncan
authors.initials: A
authors.lastname: Akdur
authors.forename: Sedat
authors.initials: S
authors.lastname: Yıldırım
authors.forename: Adnan
authors.initials: A
authors.lastname: Torgay
authors.forename: Gökhan
authors.initials: G
authors.lastname: Moray
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D016063:Blood Loss, Surgical / Q000401:mortality / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D008297:Male; D057725:Operative Blood Salvage / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult