Risk Factors of Bang et al for High Intraoperative Blood Loss During Adult Living Donor Liver Transplantation

 

Patient selection: adult living donor liver transplant

 

Outcome: volume of red blood cells lost during surgery > 1,000 mL (high intra-operative blood loss, IOBL)

 

Risk factors for high IOBL:

(1) high MELD score

(2) low serum albumin

(3) ascites

(4) previous abdominal surgery

 

The authors mention that coagulopathy (high INR, low fibrinogen) has been identified as a risk factor for bleeding but that they corrected coagulation defects prior to surgery. So uncorrected coagulopathy would be a risk factor for bleeding during surgery.

 

The cut-offs for MELD score and albumin are not given. The cut-offs used in the implementation area:

(1) serum albumin <= 2.5 g/dL (mean 2.8 +/- 0.5)

(2) MELD score >= 25 (mean 21.8 +/- 10.3, high end 32.1)