title: Recovery from Extreme Hemodilution (Hemoglobin Level of 0.6 g/dL) in Cadaveric Liver Transplantation.
abstract: Decompensated hepatic failure occurred in a patient with a rare blood type. The patient had extreme hemodilution due to massive bleeding during liver transplantation. A shortage of matched and universal donor blood prompted us to transfuse albumin and fresh frozen plasma for intravascular volume resuscitation. The lowest hemoglobin was 0.6 g/dL, accompanied by ST depression and a serum lactate of 100 mg/dL. The accuracy of the measured value of 0.6 g/dL was confirmed. However, the patient recovered from this critical situation after transfusion, and he was eventually discharged from the hospital without significant sequelae. Maintaining normovolemia, administering pure oxygen, ensuring appropriate anesthetic depth, and maintaining minimal inotropic support were essential for this patient's survival during massive bleeding.
authors.affiliation: From the Departments of *Cardiovascular Medicine and †Anesthesia and Pain Relief Center, The University of Tokyo Hospital, Tokyo, Japan; and ‡Department of Anesthesiology, Toho University Sakura Medical Center, Sakura, Chiba, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Kariya
authors.forename: Nobuko
authors.initials: N
authors.lastname: Ito
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kitamura
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Yamada
mesh_terms: D001788:Blood Grouping and Crossmatching / Q000145:classification; D016063:Blood Loss, Surgical / Q000503:physiopathology; D001803:Blood Transfusion / Q000379:methods; D002102:Cadaver; D006438:Hemodilution / Q000009:adverse effects* / Q000379:methods; D006454:Hemoglobins / Q000378:metabolism*; D006470:Hemorrhage / Q000097:blood / Q000209:etiology; D006801:Humans; D007564:Japan; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage; D010949:Plasma; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D010100:Oxygen