Blood transfusion may be detrimental to patients with cirrhosis. Wu et al identified patients with cirrhosis who did not require blood transfusion after hepatic resection of a liver tumor. The authors are from Taichung Veterans General Hospital, Chung-Shan Medical Hospital and National Yang-Ming University in Taiwan.


Cirrhotic patients who usually did not require transfusion after resection of a hepatic tumor:

(1) limited blood loss (see below)

(2) tumor < 5 cm in diameter

(3) resection confined to Couinaud's segments II, III, or VI.



• Blood loss estimates during surgery in cirrhotics is often inaccurate.

• Most cirrhotics can tolerate an estimated blood loss of <= 1,600 mL without transfusion. Some can tolerate a blood loss up to 2,350 mL without transfusion. A few may be able to tolerate an even greater blood loss.

• Couinaud divided the liver into 8 lobes. Lobes II and III are the leftmost portions of the left lobe, to the left of the round ligament. Lobe VI is the right lateral inferior segment.


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