Brems et al identified risk factors for increased blood loss in patients undergoing orthotopic liver transplantation. These can help identify patients preoperatively who may need more blood products during and after surgery. The authors are from the University of California Los Angeles (UCLA).


Risk factors associated with the greatest blood loss:

(1) age > 50 years (loss = 12 blood volumes)

(2) biliary atresia (loss = 9 blood volumes)

(3) history of portocaval shunt (loss = 18 blood volumes)

(4) history of portoenterostomy (loss = 9 blood volumes)


Additional risk factors for blood loss (loss = 6 - 7 blood volumes)

(1) age 1 to 20

(2) primary biliary cirrhosis

(3) history of sclerotherapy

(4) history of splenectomy

(5) serum total bilirubin >= 5 mg/dL



• Portoenterostomy is an operation used in the treatment of biliary atresia; it includes a Roux-en-Y anastomosis


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