Fresh Frozen Plasma in Orthotopic Liver Transplant: Friend or Foe?

BACKGROUND

Traditionally, the administration of large volumes of fresh frozen plasma (FFP) was common during liver transplant surgery, with no improvement in the results in terms of bleeding and blood-saving. Moreover, this hydric overload caused by FFP may be harmful, leading to an increase in hospital stays and patient morbidity.

METHODS

The objective is to assess the morbidity associated to the use of FFP in the intraoperative period of patients undergoing orthotopic liver transplantation. The study design is an observational retrospective study, collecting data on the transplanted patients from 2010 to 2020.

RESULTS

Acute renal failure was more frequent in the group that received FFP than in the group that did not, with a statistical difference (P = .0017). We did not find any statistical difference between the groups in terms of pulmonary complications and graft-associated thromboembolic events CONCLUSIONS: Transfusion of FFP requires large volumes to achieve a relevant elevation of coagulation factors. This hydric overload could justify the high incidence of renal complications found. Prothrombin complex could be an interesting alternative to FFP. Fibrinogen as a first-line therapy could correct perioperative bleeding and reduce the use of FFP.