Forró Melinda, Mándli Tamás
Semmelweis Egyetem Altalános Orvostudományi Kar Transzplantációs és Sebészeti Klinika, 1082 Budapest, Baross u. 23.
Magy Seb. 2002 Feb;55(1):3-8.
The advantages and disadvantages of continuous autotransfusion during liver transplantation are investigated in our study compared with blood saving and traditional cell saving techniques. Patients were divided into three groups in this retrospective study; Group 1 (n = 14): continuous autotransfusion was applied; in Group 2 (n = 14): no blood saving technique used; in Group 3 (n = 14): Haemonetics cell saver was used. In Group 1 the number of Child B patients was significantly higher than Child C patients (p < 0.05). The initial values of haemoglobin were significantly lower in Groups 1 and 3 (89 +/- 19 vs. 103 +/- 17 vs. 90 +/- 16.8 g/l; p < 0.03). During hepatectomy in Group 1 lower haemoglobin values were detected than in the other two groups (96 +/- 7 vs. 104 +/- 16 vs. 106 +/- 16.6 g/l; p < 0.05). The quantity of total blood utilisation (donor + autotransfusion) was significantly higher in Group 3 than Group 2 and in Group 1 than Group 2 (21.06 +/- 11.2 vs. 11.07 +/- 3.8 vs. 30.71 +/- 18 U; p < 0.001). Comparing the values of ACT in each group during operation periods no significant difference was found. Treatment time on the ICU of the patients in Group 3 was significantly longer than in the other two groups (11.08 +/- 7.8 vs. 9.17 +/- 3.5 vs. 26.62 +/- 14.6 days; p < 0.03). We found that applying CATS is advantageous during liver transplantation, as the device reduces donor blood requirement. No significant complication was observed.
在我们的研究中，与血液节约和传统细胞保存技术相比，对肝移植期间连续自体输血的优缺点进行了调查。在这项回顾性研究中，患者被分为三组；第1组（n = 14）：应用连续自体输血；第2组（n = 14）：未使用血液节约技术；第3组（n = 14）：使用Haemonetics细胞保存器。第1组中Child B患者的数量显著高于Child C患者（p < 0.05）。第1组和第3组的血红蛋白初始值显著较低（89±19 vs. 103±17 vs. 90±16.8 g/l；p < 0.03）。在第1组肝切除术中检测到的血红蛋白值低于其他两组（96±7 vs. 104±16 vs. 106±16.6 g/l；p < 0.05）。第3组的总血液使用量（供体 + 自体输血）显著高于第2组，第1组高于第2组（21.06±11.2 vs. 11.07±3.8 vs. 30.71±18 U；p < 0.001）。比较各手术期组内活化凝血时间（ACT）值，未发现显著差异。第3组患者在重症监护病房（ICU）的治疗时间显著长于其他两组（11.08±7.8 vs. 9.17±3.5 vs. 26.62±14.6天；p < 0.03）。我们发现，在肝移植期间应用连续自体输血系统（CATS）是有利的，因为该设备减少了对供体血液的需求。未观察到显著并发症。
