Smith O, Hazlehurst G, Brozovic B, Rolles K, Burroughs A, Mallett S, Dawson K, Mehta A
Department of Haematology, Royal Free Hospital and School of Medicine, London, U.K.
Transfus Med. 1993 Jun;3(2):97-102. doi: 10.1111/j.1365-3148.1993.tb00046.x.
A retrospective study was carried out to ascertain the blood bank provision required to support a liver transplant programme and to assess the effect of intraoperative aprotinin on blood product requirements in liver transplant recipients with cirrhosis. Sixty patients with end-stage liver disease underwent 62 consecutive orthotopic liver transplants between October 1988 and January 1991. The total and intraoperative requirements of red cells, platelets and fresh frozen plasma (FFP) were analysed for three groups of liver transplant recipients, those without cirrhosis (n = 15), those with cirrhosis (n = 25) and those with cirrhosis who received intraoperative aprotinin (n = 20). Fifteen without cirrhosis had mean total requirements of 15 units of red cells, 18 units of platelets and 16 units of FFP. Twenty patients with cirrhosis who received intraoperative aprotinin had broadly similar requirements. However, blood product requirements for 25 patients with cirrhosis were significantly greater (46 units of red cells, 41 units of platelets, 43 units of FFP, excluding the seven patients with primary biliary cirrhosis). We conclude that a liver transplant programme can be supported by a teaching hospital blood bank. The use of intraoperative aprotinin significantly reduces blood product requirements.
进行了一项回顾性研究，以确定支持肝移植项目所需的血库供应，并评估术中使用抑肽酶对肝硬化肝移植受者血液制品需求的影响。1988年10月至1991年1月期间，60例终末期肝病患者连续接受了62次原位肝移植。分析了三组肝移植受者红细胞、血小板和新鲜冰冻血浆（FFP）的总量及术中需求量，分别为无肝硬化者（n = 15）、肝硬化者（n = 25）和术中接受抑肽酶的肝硬化者（n = 20）。15例无肝硬化者的红细胞平均总需求量为15单位，血小板为18单位，FFP为16单位。20例术中接受抑肽酶的肝硬化患者的需求量大致相似。然而，25例肝硬化患者的血液制品需求量显著更高（红细胞46单位，血小板41单位，FFP 43单位，不包括7例原发性胆汁性肝硬化患者）。我们得出结论，教学医院血库可以支持肝移植项目。术中使用抑肽酶可显著降低血液制品需求量。
