Comparison of RBCs and FFP with whole blood during liver transplant surgery
- 12 March 2003
- journal article
- clinical trial
- Published by Wiley in Transfusion
- Vol. 43 (3) , 322-327
- https://doi.org/10.1046/j.1537-2995.2003.00305.x
Abstract
BACKGROUND : Component therapy has become the accepted standard of care in transfusion medicine. In instances of large blood loss, the transfusion of whole blood rather than the combination of RBCs and FFP is rational and may be preferred. STUDY DESIGN AND METHODS : In a controlled, prospective, randomized study of 33 patients undergoing orthotopic liver transplantation, the effectiveness of component therapy (RBCs and FFP) was compared with the use of whole blood. Coagulation tests (prothrombin time and activated partial thromboplastin time), clotting factor levels (FV, FVIII, fibrinogen), platelet counts, the number of donor exposures, and the total volume of blood transfused for the whole‐blood group and the component‐therapy group were compared at designated times before surgery, during surgery, and 24 hours after surgery. RESULTS : There was a significant difference (p = 0.015) in the median number of donor exposures for RBCs and FFP, with fewer occuring in the whole‐blood group (n = 14.5) compared with the component group (n = 25). There was no significant difference between groups in coagulation profiles during any of the phases of surgery except for a mild decrease in fibrinogen levels in the whole‐blood group at the conclusion of surgery. There were no differences between the groups in the median volume of blood component replacement, the median age of blood components, the patients' Hct or the number of RBC‐containing components transfused. CONCLUSION : Whole blood, when compared with component therapy, is associated with fewer donor exposures yet provided equally effective replacement therapy for blood loss in liver transplantation patients.Keywords
This publication has 7 references indexed in Scilit:
- Non-infectious complications of transfusion therapyBlood Reviews, 2001
- Practice Guidelines for Blood Component TherapyAnesthesiology, 1996
- Coagulation parameters of CPD fresh‐frozen plasma and CPD cryoprecipitate‐poor plasma after storage at 4°C for 28 daysTransfusion, 1993
- Clotting factor levels and the risk of diffuse microvascular bleeding in the massively transfused patientBritish Journal of Haematology, 1987
- Hemostasis Testing during Massive Blood Replacement A Study of 172 CasesVox Sanguinis, 1982
- Hemostasis in Massively Transfused Trauma PatientsAnnals of Surgery, 1979
- Coagulation Defects Associated with Massive Blood TransfusionsAnnals of Surgery, 1971