Patient Blood Management in Liver Transplant—A Concise Review

Author:

Pérez-Calatayud Angel Augusto1ORCID,Hofmann Axel23,Pérez-Ferrer Antonio45,Escorza-Molina Carla6ORCID,Torres-Pérez Bettina7,Zaccarias-Ezzat Jed Raful8,Sanchez-Cedillo Aczel9,Manuel Paez-Zayas Victor10,Carrillo-Esper Raul11,Görlinger Klaus1213

Affiliation:

1. Critical Care Division, Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico

2. Faculty of Health and Medical Sciences, Discipline of Surgery, The University of Western Australia, Perth 6907, WA, Australia

3. Institute of Anesthesiology, University of Zurich and University Hospital Zurich, 8057 Zurich, Switzerland

4. Department of Anesthesiology, Infanta Sofia University Hospital, 28700 San Sebastián de los Reyes, Spain

5. Department of Anesthesiology, European University of Madrid, 28702 Madrid, Spain

6. Departmen of Anesthesiology, Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico

7. Department of Anesthesiology, Pediatric Transplant, Centro Medico de Occidente, Instituto Mexicano del Seguro Social, Guadalajara 44329, Mexico

8. Surgery Department, Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico

9. Transplant Department Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico

10. Gastroenterology Department Hospital General de México Dr. Eduardo Liceaga, Mexico City 06720, Mexico

11. Academia Nacional de Medicina de México, Mexico City 06720, Mexico

12. Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, 45131 Essen, Germany

13. TEM Innovations GmbH, 81829 Munich, Germany

Abstract

Transfusion of blood products in orthotopic liver transplantation (OLT) significantly increases post-transplant morbidity and mortality and is associated with reduced graft survival. Based on these results, an active effort to prevent and minimize blood transfusion is required. Patient blood management is a revolutionary approach defined as a patient-centered, systematic, evidence-based approach to improve patient outcomes by managing and preserving a patient’s own blood while promoting patient safety and empowerment. This approach is based on three pillars of treatment: (1) detecting and correcting anemia and thrombocytopenia, (2) minimizing iatrogenic blood loss, detecting, and correcting coagulopathy, and (3) harnessing and increasing anemia tolerance. This review emphasizes the importance of the three-pillar nine-field matrix of patient blood management to improve patient outcomes in liver transplant recipients.

Funder

TEM Innovations GmbH Martin-Kollar.Str.15

Publisher

MDPI AG

Subject

General Biochemistry, Genetics and Molecular Biology,Medicine (miscellaneous)

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